Study on the predictive value of uterine artery ultrasound parameters combined with four coagulation indicators test for placental abruption in late pregnancy
10.3760/cma.j.cn115807-20230329-00094
- VernacularTitle:子宫动脉超声参数联合凝血指标检测对妊娠晚期孕妇胎盘早剥的预测价值
- Author:
Honglian ZHAO
1
;
Cui LI
;
Jie XU
;
Ping LIN
Author Information
1. 临沂市中心医院产科，临沂 276400
- Keywords:
Late pregnancy;
Placental abruption;
Uterine artery ultrasound parameters;
Coagulation indicator
- From:
Chinese Journal of Endocrine Surgery
2024;18(5):733-738
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the predictive value of uterine artery ultrasound parameters combined with four coagulation indicators test for placental abruption in late pregnancy.Methods:A total of 160 pregnant women with placental abruption during the late pregnancy who were diagnosed and treated in our hospital from Jan. 2021 to Dec. 2022 were collected as the observation group, and 160 pregnant women with normal delivery were regarded as the control group. According to different grading of placental abruption, 65 cases were classified as grade I, 54 cases as grade II, and 41 cases as grade III. Ultrasound parameters of uterine artery [uterine artery pulsatility index (PI), resistance index (RI), ratio of maximum systolic blood flow velocity (S) to maximum diastolic blood flow velocity (D) (S/D) ], and four coagulation parameters [prothrombin time (PT), fibrinogen (FIB), thrombin time (TT), and activated partial thromboplastin time (APTT) ] were compared; Logistic regression analysis was conducted to analyze the factors affecting placental abruption in late pregnancy; receiver operating characteristic (ROC) curve was applied to analyze the predictive value of uterine artery ultrasound parameters combined with four coagulation indicators test for placental abruption in late pregnancy.Results:Compared with the control group, PI, RI, and S/D ratios of pregnant women with placental abruption in the late pregnancy in the observation group were obviously increased [ (1.26 ± 0.22) vs. (0.95 ± 0.14), (0.65 ± 0.12) vs. (0.48 ± 0.06), (3.46 ± 0.63) vs. (2.57 ± 0.45) ] (P<0.05) ; compared with the control group, PT, TT, and APTT in pregnant women with placental abruption in the late pregnancy in the observation group were obviously increased [ (12.90 ± 1.42) vs. (10.24 ± 1.14), (15.06 ± 1.24) vs. (12.67 ± 1.08), (30.32 ± 2.55) vs. (25.48 ± 2.10) ] ( P<0.05), the FIB level was obviously decreased [ (3.09 ± 0.37) g/L vs. (3.96 ± 0.58) g/L] (P<0.05) ; compared with the grade I group, as the grading of placental abruption increased, PI, RI, S/D ratio, PT, TT, and APTT in grade II group and grade III group increased in turn ( P<0.05) and the level of FIB decreased in turn ( P<0.05) ; Logistic regression analysis showed that mechanical injury, polyhydramnios, premature rupture of membranes, pregnancy diabetes, pregnancy induced hypertension, PI, RI, S/D ratio, PT, TT, APTT were the risk factors for placental abruption in late pregnancy ( P<0.05), and FIB was the protective factor for placental abruption in late pregnancy ( P<0.05) ; the area under the ROC curve (AUC) the combined detection of PI, RI, S/D ratio, PT, FIB, TT, and APTT for placental abruption in late pregnancy was 0.982, which was better than their individual predictions (Z combined test-PI=6.118, P<0.001; Z combined test-RI=6.080, P<0.001; Z combined test-S/D ratio=6.690, P<0.001; Z combined test-PT=5.837, P<0.001; Z combined test-FIB=6.500, P<0.001; Z combined test-TT=6.439, P<0.001; Z combined test- PTT=6.112, P<0.001) . Conclusions:The PI, RI, S/D ratio, PT, TT, APTT increase, and FIB level decreases in pregnant women with placental abruption in the late pregnancy, they are related to different grades of placental abruption. Combined detection has good predictive value for placental abruption in pregnant women in the late pregnancy.
