孕6~9周孕囊平均直径与胎儿头臀长之差对妊娠结局的预测

Prediction of pregnancy outcome by the difference between the mean diameter of gestational sac and fetal head-rump length at 6-9 weeks of gestation

目的探讨孕囊平均直径(mGSD)与胎儿头臀长(CRL)的差值与妊娠结局的相关性。方法回顾性选取2019年1月—6月在某院进行超声检查,孕周为6~9周的早期妊娠患者638例,测量mGSD与CRL,根据妊娠结局分为持续妊娠组与自然流产组。结果mGSD-CRL值在持续妊娠组与自然流产组早孕期不同孕龄段组间差异均具有统计学意义;mGSD-CRL值6周ROC曲线下面积(AUC)为0.609,95%CI(0.468,0.750),9周ROC曲线下面积(AUC)为0.684,95%CI(0.444,0.925),诊断价值较低,临界值分别为12.83 mm及9.17 mm;7周ROC曲线下面积(AUC)为0.826,95%CI(0.734,0.919),8周ROC曲线下面积(AUC)为0.741,95%CI(0.553,0.929),诊断价值中等,临界值分别为9.59 mm及9.50 mm。结论mGSD-CRL对妊娠结局具有较好的预测价值,可作为自然流产的预测指标。当mGSD-CRL值出现异常时,流产的机率增加,临床有必要进行更密切的随访。

Objective To investigate the correlation between the difference between the mean gestational sac diameter(mGSD)and crown-rump length(CRL)and pregnancy outcome.Methods 638 early pregnancy patients with gestational weeks of 6-9 weeks who underwent ultrasonography in our hospital from January 2019 to June 2019 were retrospectively selected.mGSD and CRL were measured.They were divided into continuous pregnancy group and spontaneous abortion group according to pregnancy outcome.Results There was significant difference in mGSD-CRL value between continuous pregnancy group and spontaneous abortion group at different gestational ages in early pregnancy;The area under ROC curve(AUC)at 6 weeks was 0.609,95%CI(0.468,0.750),and the area under ROC curve(AUC)at 9 weeks was 0.684,95%CI(0.444,0.925).The diagnostic value was low,and the critical values were 12.83 mm and 9.17 mm respectively;The area under ROC curve(AUC)at 7 weeks was 0.826,95%CI(0.734,0.919),and the area under ROC curve(AUC)at 8 weeks was 0.741,95%CI(0.553,0.929).The diagnostic value was medium,and the critical values were 9.59 mm and 9.50 mm respectively.Conclusion mGSD-CRL has good predictive value for pregnancy outcome and can be used as a predictor of spontaneous abortion.When the value of mGSD-CRL is abnormal,the probability of abortion increases.It is necessary to follow up more closely in clinic.