血清学指标预测前置胎盘并发胎盘植入的价值

Clinical value of maternal serum markers in predicting placenta praevia complicated with placenta implantation

目的:探讨中孕血清学筛查指标在前置胎盘患者中预测胎盘植入的价值。方法:回顾性分析55例前置胎盘患者的临床资料,收集中孕血清学筛查的游离人绒毛膜促性腺激素β亚基(f-βh CG)和甲胎蛋白(AFP)的MOM值进行统计分析。结果:f-βh CG MOM和AFP MOM预测胎盘植入的ROC曲线下面积(AUC)分别为0.882(P<0.001,95%CI:0.78~0.99)和0.927(P<0.001,95%CI:0.86~1.00),分别选择1.50和1.07作为临界值,预测胎盘植入的灵敏度为76.47%和94.12%,特异度为92.11%和78.95%。结论:中孕血清学筛查指标对于前置胎盘并发胎盘植入具有较好的预测价值。

Objective:To evaluate the clinical value of maternal serum markers in predicting placenta praevia in patients complicated with placenta implantation.Methods:Clinical data were obtained from 55 cases of placenta praevia complicated placenta implantation,and retrospectively analyzed regarding the multiples of the expected median(MOM)including serum levels of free human chorionic gonadotropinβsubunit(f-βhCG)andα-fetoprotein(AFP).Results:The area under the ROC curve(AUC)of f-βhCG MOM and AFP MOM to predict placenta praevia and placental implantation were 0.882(P<0.001;95%CI:0.78~0.99)and 0.927(P<0.001;95%CI:0.86~1.00),respectively.By cutoff value of 1.50 and 1.07,the sensitivity and specificity of the two serum predictors were 76.47%and 94.12%,92.11%and 78.95%,respectively.Conclusion:Maternal serum markers determined in the second-trimester has good predictive value in placenta praevia in pregnancies complicated with placenta implanation.