Application Of Serum Markers Combined With Color Doppler Ultrasound In The Prenatal Diagnosis Of Implantation Of Pernicious Placenta Previa

Objective: To compare and analyze the levels of serum matrix metalloproteinase-9(MMP-9)and creatine kinase(CK)in the prenatal diagnosis of implantation of pernicious placenta previa and non-placenta previa and non-implanted patients,and analyze the application value of them combined with color Doppler ultrasound in prenatal diagnosis.Methods: 50 patients with implantation of pernicious placenta previa who were delivered in the First Affiliated Hospital of Bengbu Medical College from January 2019 to August 2020 were selected as the observation group(3 patients with penetrating type,31 patients with implanted type,16 patients with adhesive type),50 cases of non-placenta previa and non-implanted patients served as the control group.Each group was diagnosed by clinical and postoperative pathology,Color Doppler ultrasound,MMP-9,CK examinations are performed after admission.The independent sample t test was used to compare two groups of general information,one-way analysis of variance was used to compare the levels of MMP-9 and CK in each group,the cut-off value of the variable is obtained through the ROC curve,the Delong test compares the area under the ROC curve(AUC)of each indicator individually and in combination,and compares the respective Youden index.Results: There was no significant difference between the observation group and the control group in general information(age,gestational age,gestation times,parity)(t=1.855,0.669,1.666,0.267,P>0.05),and the differences in the levels of MMP-9 and CK in each group were statistically significant(F=43.134 、 22.600,P<0.05),the observation group is higher than the control group,the level of CK in the penetrating type was higher than that in the implanted type,the implanted type is higher than adhesive type and control group,and the level of MMP-9 was higher in the penetrating and implanted type than in the control group(P<0.05).The best cut-off values of serum CK and MMP-9 for diagnosing implantation of pernicious placenta previa are 38.00U/L and 362.90 ng/m L respectively.The AUC(0.902)and Youden index(0.76)for combined diagnosis of CK,MMP-9 and color Doppler ultrasound were significantly greater than the diagnosis of each individual index.Conclusion: Prenatal MMP-9 and CK levels are significantly increased in the serum of implantation of pernicious placenta previa patients,and the combination of MMP-9 and CK levels with color Doppler ultrasound is beneficial to improve the prenatal diagnosis value of this disease.And it is superior to the detection value of each individual index,which provides a certain reference value for the prenatal diagnosis,prevention and treatment of implantation of pernicious placenta previa.