Value of Doppler ultrasound blood flow parameters of uterine artery combined with screen of serological indexes in the second trimester for predicting the adverse pregnancy outcomes
Zou Kuangni, Jiang Chunrong, Zhang Surong
Department of Ultrasound Imaging, Guangyuan Maternal and Child Health Hospital, Sichuan, Guangyuan 628000, China
Abstract: 【Abstract】 Objective To investigate the value of Doppler ultrasound blood flow parameters of uterine artery combined with prenatal screen of serological indexes in the second trimester for predicting the adverse pregnancy outcomes. Method From December 2018 to May 2020, 782 pregnant women who underwent prenatal examination and gave birth in Guangyuan Maternal and Child Health Hospital were included as the research objects. At 15~20+6 weeks, the uterine artery blood flow parameters [pulsatility index (PI) and blood flow resistance index (RI)] were measured by Doppler ultrasound. The serum β-human chorionic gonadotropin (β-hCG), unconjugated estriol (uE3) and alpha-fetoprotein (AFP) were detected,while the multiple of median (MoM) values were calculated. Followed up to 42 days postpartum, they weredivided into adverse group and normal group according to the pregnancy outcome. Chi-square test, t test,nonparameter test, multivariate Logistic regression analysis, receiver operating characteristic (ROC) curvewere used for statistical analysis. Result Of the 782 pregnant women, 718 pregnant women (91.8%) had normal pregnancy (normal group); 64 cases (8.2%) of pregnant women had adverse pregnancy outcomes(adverse group). PI score[2 (1, 4) vs 1 (0, 1)], RI value [0.64 (0.48, 0.83) vs 0.43 (0.34, 0.54)], the MoM value of β-hCG [1.34 (0.80, 2.12) vs 0.69 (0.26, 1.23) IU/L] and the MoM value of AFP [0.98 (0.56, 2.27)vs 0.63 (0.32, 1.44) μg/L] in the adverse group were higher than those in the normal group(P<0.05).The MoM value of uE3 in the adverse group was lower than that of normal group [0.63 (0.28, 0.96)vs 0.80 (0.31, 1.55) nmol/L, P<0.05]. Multivariate Logistic regression analysis showed that PI score increased (OR=3.917, 95%CI: 2.675-5.736), RI value increased (OR=143.247, 95%CI: 28.726-714.313),β-hCG increased (OR=3.050, 95%CI: 2.002-4.647), AFP increased (OR=1.844, 95%CI: 1.292-2.631) anduE3 decreased (OR=0.556, 95%CI: 0.316~0.977) might be risk factors for adverse pregnancy outcomes(all P<0.05). ROC curve analysis showed that the AUC of PI scores in predicting the adverse pregnancy outcomes was 0.796 while the cut-off was 1.50. The AUC of RI was 0.791, while the cut-off was 0.62. The AUC of β-hCG was 0.742, while the cut-off was 0.85 IU/L. The AUC of uE3 was 0.575, while the cut-off was 0.96 nmol/L. The AUC of AFP was 0.675, while the cut-off was 1.97 μg/L. The AUC of the five indexes combined was 0.929, which was higher than that of single index. Conclusion Abnormal ultrasonic blood flow parameters and serological indexes of uterine artery in the second trimester of pregnancy are related to adverse pregnancy outcomes. The increase of PI score, RI value, β-hCG and AFP, and the decrease ofuE3 may be the risk factors of adverse pregnancy outcomes. Combined detection is helpful to improve the prediction effect of adverse pregnancy outcomes.
邹旷妮 姜春蓉 张素蓉. 孕中期子宫动脉多普勒超声血流参数联合血清学指标预测不良妊娠结局的价值[J]. 发育医学电子杂志, 2022, 10(3): 189-195.
Zou Kuangni, Jiang Chunrong, Zhang Surong. Value of Doppler ultrasound blood flow parameters of uterine artery combined with screen of serological indexes in the second trimester for predicting the adverse pregnancy outcomes. Journal of Developmental Medicine(Electronic Version), 2022, 10(3): 189-195.
2022, Vol. 10 
