[1]聂红艳*,王利顺,陈伟伟,等.子宫动脉多普勒超声联合产前筛查指标MoM值 预测15~20周孕妇不良妊娠结局的临床价值[J].中国计划生育和妇产科,2019,(7):55-59.
　NIE Hong-yan*,WANG Li-shun,CHEN Wei-wei,et al.Clinical value of doppler ultrasound combined with prenatal screening index MoM to predict adverse pregnancy outcome in 15~20 w pregnant women[J].Chinese Journal of Family Planning & Gynecotokology,2019,(7):55-59.
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子宫动脉多普勒超声联合产前筛查指标MoM值 预测15~20周孕妇不良妊娠结局的临床价值
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2019年7期
页码:
55-59
栏目:
论著与临床
出版日期:
2019-06-25

文章信息/Info

Title:
Clinical value of doppler ultrasound combined with prenatal screening index MoM to predict adverse pregnancy outcome in 15~20 w pregnant women
作者:
聂红艳1*; 王利顺2; 陈伟伟1; 庞静1; 秦桂莲1; 侯凌云3; 白力伟3
秦皇岛市妇幼保健院，1.超声科；2.放射科；3.产科
Author(s):
NIE Hong-yan1*; WANG Li-shun2; CHEN Wei-wei1; PANG Jing1; QIN Gui-lian1; HOU Ling-yun3; BAI Li-wei3
1.Ultrasound Department；2.Radiology Department；3.Obstetric Department，Maternal and Child Health Care of Qinhuangdao City，Qinhuangdao Hebei 066000，P.R.China
关键词:
子宫动脉; 超声多普勒; 妊娠结局; 产前筛查; 甲胎蛋白; 游离雌三醇 ; β-人绒毛膜促性腺激素
Keywords:
uterine artery;  ultrasound Doppler;  pregnancy outcome;  prenatal screening;  alpha-fetoprotein;  free estriol;  beta human chorionic gonadotropin
分类号:
R 714.46
摘要:
目的探讨子宫动脉多普勒超声联合产前筛查指标MoM值预测15~20周孕妇不良妊娠结局的临床价值。方法选择秦皇岛市妇幼保健院2014年1月至2017年4月收治的1 900例孕妇，孕周15~20周接受多普勒超声检查，测定子宫动脉指数(pulsatility index，PI），并行血清产前筛查，包括血清甲胎蛋白（α-fetoprotein，AFP）、游离雌三醇（unconjugated estriol，uE3）、β-人绒毛膜促性腺激素（beta human chorionic gonadotropin，β-hCG），随访至产后42 d，将孕妇分为不良妊娠结局组和正常妊娠结局组，分析多普勒超声联合产前筛查指标MoM值预测不良妊娠结局的效果。结果正常妊娠结局组1 674例，不良妊娠结局组226例（119 %），不良妊娠结局组PI评分、血清AFP和β-hCG显著高于正常妊娠结局组，血清uE3水平显著低于正常妊娠结局组，差异有统计学意义（P<005）；Logistic回归分析显示PI、AFP、uE3、β-hCG均为预测不良妊娠结局的有效指标；PI+ AFP+uE3+β-hCG平行联合预测敏感度显著高于AFP+uE3+β-hCG（P<005），系列联合检测特异度、准确度及ROC曲线下面积显著高于AFP+uE3+β-hCG（P<005）。结论孕中期子宫动脉多普勒超声平行联合产前筛查指标MoM值有助于提高不良妊娠结局预测的敏感度，系列联合检测有助于提高预测的特异度和准确度，对于不良妊娠结局预测和干预具有重要指导价值。
Abstract:
Objective To explore the clinical value of doppler ultrasound combined with prenatal screening index MoM to predict adverse pregnancy outcome in 15-20 w pregnant women. Methods1 900 pregnant women admitted in Maternal and Child Health Care of Qinhuangdao City from January 2014 to April 2017 received Doppler ultrasound examination，measured of uterine pulsatility index (PI) and serum prenatal screening，including alpha-fetoprotein (AFP), unconjugated estriol (uE3), beta human chorionic gonadotropin (beta-hCG) at 15 to 20 of gestational weeks, and followed up to 42 days postpartum. All pregnant women were divided into adverse pregnancy outcome group and normal pregnancy outcome group, to compare the effect of Doppler ultrasound combined with prenatal screening index MoM value on adverse pregnancy outcome. ResultsThere were 1 674 cases of normal pregnancy outcomes and 226 cases (119 %) of adverse pregnancy outcomes. The PI score, serum AFP and β-hCG in the adverse pregnancy outcome group were significantly higher than those in the normal pregnancy outcome group, and the serum uE3 level was significantly lower than that in the normal pregnancy outcome group (P<005). Logistic regression analysis showed that PI, AFP, uE3 and β-hCG were effective indicators for predicting adverse pregnancy outcomes. The sensitivity of parallel combination PI+AFP+uE3+β-hCG was significantly higher than AFP+uE3+β-hCG (P<005), specificity, accuracy and area under ROC curve series combination were significantly higher than AFP+uE3+β-hCG (P<005). ConclusionDoppler ultrasound parallelly combined with the MoM value of the prenatal screening index in the second trimester helps to improve the sensitivity of prediction of adverse pregnancy outcomes, and series combination can improve the specificity and accuracy of the prediction, which is of great important and guiding value in prediction and intervention of adverse pregnancy outcomes.

参考文献/References:

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备注/Memo

备注/Memo:
秦皇岛市科技支撑计划项目（项目编号：201703A129）
更新日期/Last Update: 2019-07-25