绒毛膜隆起的腔内二维和三维超声量化指标与早期妊娠结局的相关性研究

Study on the correlation between two-dimensional and three-dimensional ultrasound quantification indicators of chorionic bumpssand1early pregnancy outcomes

目的探讨腔内二维(transvaginal two-dimensional ultrasound,2D-TVS)、三维(transvaginal three-dimensional ultrasound,3D-TVS)超声指标用于评估绒毛膜隆起(chorionic bumps,CB)的临床意义。方法回顾性分析2019年1月至2022年4月在山东中医药大学附属医院进行早期妊娠检查的孕妇11042例,其中CB病例46例,纳入CB组;其余早孕期孕妇,抽取421例纳入对照组,比较两组早期妊娠结局。根据早期妊娠结局将CB组分为流产和宫内活胎两个亚组。按照CB数目将CB组分为CB=1和CB>1两个亚组。2D-TVS记录妊娠囊(GS)和CB前后、上下、左右径及CB数目,计算GS均值、CB均值、CB/GS均值比;3D-TVS获取GS、CB体积,并计算CB/GS体积比。比较两亚组超声指标,分析超声指标与早期妊娠结局相关性。结果CB的发生率为0.42%。CB组早期妊娠流产率为55.6%,高于对照组(5.1%),差异有统计学意义(P<0.05)。流产组和宫内活胎组GS均值、GS体积、CB均值、CB体积及CB数目比较,差异无统计学意义(P>0.05);流产组CB/GS均值比、CB/GS体积比大于宫内活胎组,差异有统计学意义(P<0.05)。CB/GS体积比与早期妊娠流产具有相关性(P<0.05),相关系数为0.409;其他超声指标与早期妊娠流产无相关性(P>0.05)。CB=1组流产率(58.6%)与CB>1组流产率(42.9%)比较,差异无统计学意义(P>0.05)。结论CB/GS均值比、CB/GS体积比与早期妊娠结局有关,CB/GS体积比与早期妊娠流产率呈正相关。CB作为孕早期预后不良的超声征象,有增加早期妊娠流产的可能。

Objective To explore the clinical significance of transluminal two-dimensional ultrasound(2D-TVS)and threedimensional ultrasound(3D-TVS)in evaluating chorionic bumps(CB).Methods A total of 11042 pregnant women who underwent early pregnancy examinations at the Afiliated Hospital of Shandong University of Traditional Chinese Medicine from January 2019 to April 2022 were included in the retrospective analysis.Among them,46 cases of CB were included in the CB group.421 other early pregnant women were selected and included in the control group,and their early pregnancy outcomes were compared.The CB group was divided into the miscarriage subgroup and intrauterine live fetus subgroup according to early pregnancy outcomes.The CB group was divided into CB=1 subgroup and CB>1 subgroup according to the CB number.2D-TVS records the gestational sac(GS),the anteroposterior diameter,upper and lower diameters,left and right diameters and number of CB,and calculated CS average,CB average and CB/CS average ratio.3D-TVS obtains the CS and CB volumes and calculates the CB/GS volume ratio.To compare the ultrasound indicators of two subgroups and analyse the correlation between ultrasound indicators and early pregnancy outcomes.Results The incidence of CB was 0.42%,the probability of miscarriage at early-stage gestation was 55.6% in the CB group,which were significantly higher than that in the control group(5.1%),and the difference was statistically significant(P<0.05).Compare the GS average,GS volume,CB average,CB volume and CB number between the abortion group and the intrauterine live fetus group,the difference was not statistically significant(P>0.05).The CB/GS average ratio and the volume of CB/GS in the abortion group were larger than those in the intrauterine live fetus group,and the differences were statistically significant(P<0.05).The volume ratio(CB/CS)was correlated with miscarriage at early-stage gestation(P<0.05),the correlation coefficients was 0.409,while there was no correlation in other indexes(P>0.05).There was no statistically significant difference in the abortion rate between CB=1 group(58.6%)and CB>1 group(42.9%)(P>0.05).Conclusions The CB/CS average ratio and CB/GS volume ratio are associated with early pregnancy outcomes.CB/CS volume ratio is positively correlated with early pregnancy miscarriage rate.CB,as an ultrasound sign with poor prognosis in early pregnancy,has the potential to increase the risk of miscarriage in early pregnancy.