Zhenduanxue lilun yu shijian (Oct 2021)
Prediction value of first trimester ultrasound parameters for pregnancy outcome
Abstract
Objective: To explore the predictive value of ultrasonographic parameters in the first trimester pregnancy outcomes. Methods: A total of 1 651 pregnancy were enrolled, and ultrasonographic parameters including fetal heart rate(FHR), mean gestation sac diameter(MSD) and crown to rump length (CRL) at or before 7 weeks′ gestational age were measured, and the sonogram obtained at or before 13 weeks′ gestation to determine the embryo survived or demise.It revealed that 1 556 cases were classified into ongoing pregnancy group and 95 cases were into spontaneous abortion group. Results: Before 13 weeks′, the spontaneous abortion rate was 5.85% in the study. Pregnancy loss occurred in all the cases with the FHR slower than or equal to 80 bpm (100%), while in fetal with FHR>90 bpm decreased significantly (2.51%). The survival rate increased with the increase of FHR when FHR≤130 bpm, while the fetal demise rate increased as FHR>130 bpm(2.79%). The spontaneous abortion rate was 57.14% as MSD-CRL≤5 mm. The bigger the MSD-CRL was, the higher the survival rate was. Receiver operating characteristic (ROC) curve analysis demonstrated that AUC of FHR=97 bpm for poor pregnancy outcome was 0.870 (P<0.05), while sensitivity, specificity, PPV and NPV were 81.05%, 99.04%, 83.7% and 98.8% respectively. When MSD-CRL was taken as 11.3 mm, AUC for prediction of spontaneous abortion was 0.780(P<0.05), with sensitivity, specificity, PPV and NPV values were 56.84%, 89.01%, 24.00% and 97.10% respectively. When the combination of FHR and MSD-CRL, the AUC for prediction of spontaneous abortion was 0.922(P<0.05). Conclusions: The spontaneous abortion rate was 5.85% in the study. The cut-off value for FHR and MSD-CRL to predict abortion are 94 bpm and of 11.3 mm, respectively. The lower the fetal heart rate and the smaller MSD-CRL diameter are, the higher the spontaneous abortion rate will occur.
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