A Clinical Research On The Dynamic Monitoring Of Early Pregnancy Abortion By Estradiol Slope Formula

Objective: The Estradiol(E2) slope formula was obtained by Receiver Operator Characteristic curve(ROC curve) and regression analysis to seek a simple and effective monitoring index to improve the clinical diagnostic level of early pregnancy abortion.Methods: On early pregnancy(4-12 weeks), the serum levels of Estradiol(E2) and Progesterone(P) in 237 cases with inevitable abortion groups and 1012 cases with continuous pregnancy groups who were treated in our center were analyzed retrospectively. The levels of E2 and P were evaluated by Receiver Operator Characteristic curve(ROC curve) to obtain the optimal critical value(Cut-off value) in every pregnant week. Compared the diagnostic accuracy of abortion of Cut-off values by Group external validation. The slope of Estradiol was obtained by regression analysis.Results:(1)ROC curve analysis showed that the Cut-off value of E2 in the diagnosis of abortion(4-10 weeks) was: 213pg/ml,259.5 pg/ml,499.5 pg/ml,526 pg/ml,806.5 pg/ml,835 pg/ml and 1043.5 pg/ml respectively, corresponding accuracy was: 67.6%,73.2%,81.7%, 86.9%,91.5%,95.5% and 98.2% respectively.(2)ROC curve analysis showed that the Cut-off value of P in the diagnosis of abortion(4-10 weeks) was: 25.685 ng/ml,29.565 ng/ml,24.965 ng/ml,25.39 ng/ml,29.27 ng/ml,30.425 ng/ml and 26.545 ng/ml respectively, corresponding accuracy was: 71.8%,72.3%,82.1%,85.0%,91.1%, 95.5% and 97.5% respectively.(3)Group external validation of the Cut-off values showed that the diagnostic accuracy of abortion of Estrogen was higher than P( P<0. 05).(4)There was a significant positive linear relationship between the Cut-off value of E2 and the gestational age, R2=0.968, The slope of Estradiol(K) was 141. When gestational age was brought into Estradiol slope formula, the low limit safety value of E2(pg/ml) =174+(gestational week-4) ×K(4-10 weeks). Corresponding diagnostic accordance rates of the low limit safety value of E2 was: 66.2%, 75.6%, 83.6%,85.9%,90.6%,95.0% and 97.5% respectively, it was similarity than the Cut-off value of E2(P> 0. 05).Conclusion: Dynamic determination of Estradiol and Progesterone levels can be used as a reliable predictor of early pregnancy abortion. Estradiol slope gestation formula were: the serum level of E2(pg/ml) =174+(gestational week-4) ×K, it can be simple and accurate to diagnose early pregnancy abortion. Monitoring the slope of Estradiol to diagnose early pregnancy abortion in clinical were feasible, innovative and scientific.