| Objective:To study the diagnostic efficacy of β-h CG,progesterone,estradiol and abdominal color Doppler ultrasound in ectopic pregnancy,and analyze its application value in the diagnosis of early ectopic pregnancy.Method: Fifty-six women who were examined and diagnosed as ectopic pregnancy in our hospital from December 2020 to March 2022 were selected as the ectopic pregnancy group,and 72 women who were examined and confirmed as normal intrauterine pregnancy in our hospital during the same period were recorded as the intrauterine pregnancy group.The two groups finally obtained 128 cases according to the inclusion and exclusion criteria.(1)Collect and record the names,ages,gestational weeks,menstrual history,marriage and childbearing history,adverse pregnancy and childbirth history,pelvic surgery history,vaginal bleeding and other basic clinical data of the two groups of patients.Both groups were tested for serum HCG,progesterone,estradiol and color ultrasound of vagina at 8-10 a.m.(2)To analyze the correlation between the basic clinical characteristics of patients and pregnancy outcome.(3)The data were recorded by SPSS 23.0 software to statistically analyze the diagnostic efficacy of serum HCG,progesterone,estradiol and color Doppler ultrasound in ectopic pregnancy in the two groups of patients.Result:1.There were no significant differences in age,birth history,abdominal pain and vaginal bleeding between the two groups(P > 0.05),but the incidence of ectopic pregnancy in the elderly was higher than that in the non-elderly(P < 0.05)The incidence of ectopic pregnancy in women with adverse pregnancy and delivery history was higher than that in women without adverse pregnancy and delivery history,the difference was statistically significant(P< 0.05)The incidence of ectopic pregnancy in women with pelvic operation history was significantly higher than that in women without pelvic operation history(P < 0.05).2.In each individual test,the best cutoff value of progesterone is 14.670ng/m L.Under the above optimal critical value,its AUC is 90.2%,its sensitivity to early ectopic pregnancy is 87.5%,specificity is 79.2%,the maximum Youden index is 0.667,positive predictive value is 76.6%,and negative predictive value is 89.1%;The best cutoff value of estradiol is 353.3 pg/m L.Under the above optimal critical value,its AUC is 86.8%,its sensitivity to early ectopic pregnancy is 87.5%,its specificity is 72.2%,the maximum Youden index is 0.597,the positive predictive value is 71.0%,and the negative predictive value is 88.1%;The optimal cut-off value of HCG is 8299 m IU/ml.Under the above optimal threshold value,its AUC is 89%,its sensitivity to early ectopic pregnancy is 89.3%,its specificity is 79.2%,the maximum Youden index is 0.685,the positive predictive value is 76.9%,and the negative predictive value is 90.5%;The optimal cutoff value of endometrial thickness is12.5mm.Under the above optimal threshold,its AUC is 87.9%,its sensitivity to early ectopic pregnancy is 74.1%,specificity is 77.78%,the maximum Youden index is 0.635,positive predictive value is 75.0%,and negative predictive value is 87.5%.3.Among the combined tests,the AUC of β-h CG,,progesterone and color Doppler ultrasound was95.4%,its sensitivity to early ectopic pregnancy was 92.9%,specificity was 87.5%,the maximum Youden index was 0.804,positive predictive value was 85.2%,and negative predictive value was 94%;The AUC of β-h CG,,progesterone and estradiol was 94.9%,its sensitivity to early ectopic pregnancy was 91.1%,specificity was 84.7%,the maximum Youden index was 0.759,positive predictive value was 82.3%,and negative predictive value was 92.4%;The AUC of β-h CG,progesterone,estradiol and color Doppler ultrasound was 95.5%,its sensitivity to early ectopic pregnancy was 94.6%,specificity was 84.7%,the maximum Youden index was 0.794,positive predictive value was 83.0%,and negative predictive value was 95.3%.Conclusion:1.Age,abdominal pain and vaginal bleeding were not significant in the diagnosis of ectopic pregnancy in this study.The high risk factors of ectopic pregnancy were advanced age,history of pelvic operation,history of adverse pregnancy and repeated ectopic pregnancy.2.The detection of serum HCG,progesterone,estradiol and endometrial thickness has certain diagnostic significance in predicting pregnancy outcome.When HCG < 8299 m IU/ml,progesterone < 14.67 ng/m L,estradiol <353.3 pg/m L,and endometrial thickness < 12.5 mm,it is helpful to predict the high incidence of ectopic pregnancy.In addition,β-h CG has the highest diagnostic value for ectopic pregnancy in each individual statistical analysis.3.The combined detection ofβ-h CG,progesterone,estradiol and endometrial thickness has higher diagnostic value than the single detection,and has higher reference value for the diagnosis of ectopic pregnancy in clinic. |
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