妊娠晚期血浆D-二聚体水平对不良妊娠结局的影响

Effects of plasma D-dimer level in the third trimester on poor pregnancy outcomes

目的探究妊娠晚期血浆D-二聚体对不良妊娠结局的影响。方法回顾性分析2020年9月~2021年9月于我院妇产科规律产检的210例孕产妇临床资料,将发生不良妊娠结局的46例孕产妇归入不良妊娠组,未发生不良妊娠结局的164例孕产妇归入良好妊娠组,比较两组孕产妇一般资料和妊娠晚期(≥28周)D-二聚体检测水平,以受试者特征工作曲线(ROC曲线)评价妊娠晚期D-二聚体预测不良妊娠结局的价值。结果不良妊娠组孕产妇妊娠晚期D二聚体水平显著高于良好妊娠组(P<0.05);ROC曲线分析显示,妊娠晚期D-二聚体预测不良妊娠结局的曲线下面积为0.865(95CI%:0.812~0.908),截断值1.34 mg/ml,对应诊断敏感性为75.00%、特异性为80.43%。结论妊娠晚期血浆D-二聚体可作为预测不良妊娠结局的检测指标,临床应重视妊娠晚期D-二聚体异常升高的孕产妇,采取合适的干预措施以保障母婴安全。

Objective To explore the effects of plasma D-dimer level in the third trimester on poor pregnancy outcomes.Methods The clinical data of 210 pregnant and lying-in women who received regular obstetric examination in department of obstetrics and gynecology of the hospital were retrospectively analyzed between September 2020 and September 2021.46 pregnant and lying-in women with poor pregnancy outcomes were classified as the poor pregnancy group,and 164 pregnant and lying-in women without poor pregnancy outcomes were included in the good pregnancy group.The general data of pregnant and lying-in women and the level of D-dimer in the third trimester(≥28 weeks)were compared between the two groups,and receiver characteristic operating curve(ROC curve)was used to evaluate the value of D-dimer in the third trimester on predicting the poor pregnancy outcomes.Results The level of D-dimer in the third trimester of pregnant and lying-in women in the poor pregnancy outcome group was significantly higher than that in the good pregnancy outcome group(P<0.05).ROC curve analysis showed that the area under the curve of D-dimer in the third trimester for predicting poor pregnancy outcomes was 0.865(95CI%:0.812-0.908),with the cut-off value of 1.34 mg/ml,corresponding diagnostic sensitivity of 75.00%and specificity of 80.43%.Conclusion Plasma D-dimer in the third trimester can be used as a detection indicator in predicting poor pregnancy outcomes.It is necessary to pay attention to pregnant and lying-in women with abnormally elevated D-dimer in the third trimester and to take appropriate intervention measures so as to ensure the maternal-infant safety.