The Predictive Value Of Secondary Pregnancy Serum Biochemical Markers Combined With Doppler Ultrasound In Pre-eclampsia

Objective Serum placental growth factor(PLGF),soluble fms-like tyrosine kinase-1(s Flt-1)and their ratios combined with tertiary color Doppler ultrasound to predict the occurrence of preeclampsia and severe preeclampsia were predicted by serum placental growth factor(PLGF),soluble fms-like tyrosine kinase-1(s Flt-1)and their ratios combined with tertiary color Doppler ultrasound,and early screening and early prevention were carried out,which effectively reduced the incidence of preeclampsia and reduced adverse maternal and infant pregnancy outcomes.Methods A total of 281 pregnant women from the Affiliated Hospital of Inner Mongolia Medical University were selected for regular prenatal examination from December 2021 to January 2023,venous blood was drawn to detect PLGF and s Flt-1at 22～24 weeks of pregnancy and the ratio was calculated,and the PI and RI parameters were examined by tertiary color Doppler ultrasound at the same time,and follow-up to delivery or artificial termination of pregnancy.According to the inclusion criteria,there were 227 cases in the control group,28 cases in the preeclampsia group,and 26 cases in the severe preeclampsia group.The three groups of serum markers and uterine arterial blood flow parameters were subjected to nonparametric rank sum test and univariate ANOVA,the Kluscal-Wallis test and LSD-t test were used to compare between groups,the combined predictor model was established by logistic regression analysis,and the ROC curve analysis was drawn to explore the predictive value of each index alone and in combination for preeclampsia and severe preeclampsia.Results1.A total of 281 cases were included in this study,including 227 cases in the control group,28 cases in the preeclampsia group and 26 cases in the severe preeclampsia group.2.After one-way ANOVA,there was no significant difference in gestational age and age of pregnant women between the three groups(P>0.05).3.The ratios of s Flt-1,PLGF and s Flt-1/PLGF in the three groups were analyzed by nonparametric rank and non-parametric rank test(P<0.05).The Kluscal-Wallis test was used to analyze that the ratios of s Flt-1 and Flt-1/PLGF in the preeclampsia group and severe preeclampsia group were significantly higher than those in the control group,and the PLGF was significantly lower than that in the control group,with a statistically significant difference(P<0.05),and there was no significant difference in the ratios of s Flt-1,PLGF and s Flt-1/PLGF in the severe preeclampsia group compared with the preeclampsia group(P>0.05).4.The PI and RI values of pregnant women in the three groups were analyzed by LSD-t test,and the PI and RI values of the preeclampsia group and the severe preeclampsia group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05);the difference in PI and RI values between the severe preeclampsia group and the preeclampsia group was not statistically significant(P>0.05).5.Three sets of combined predictor models were established by binary logistic regression analysis,and the predictive value of preeclampsia was plotted by ROC curve analysis: the area under the curve(AUC)of s Flt-1/PLGF+PI+RI model was greater than that of other individual indicators and joint prediction models: 0.97(0.84,0.80,0.92,0.82,0.86,0.94,0.90),the highest prediction efficiency,sensitivity and scificity > 90%.6.Three joint predictor models were established by binary logistic regression analysis,and the predictive value of ROC curve analysis for severe preeclampsia was plotted: the area under the curve(AUC)of s Flt-1/PLGF+PI+RI model was greater than that of other individual indicators and joint prediction models: 0.99(0.79,0.86,0.98,0.85,0.85,0.93,0.94),with the highest prediction efficiency and > sensitivity and scificity of 95%.Conclusion1.Serum s Flt-1,PLGF,s Flt-1/PLGF ratios and uterine arterial blood flow index PI and RI values have predictive efficacy on preeclampsia and severe preeclampsia,but s Flt-1/PLGF ratio combined with uterine arterial blood flow index PI and RI has the highest predictive efficiency,sensitivity and scificity.2.For pregnant women in 22～24 weeks in this area,it is recommended to rform serum s Flt-1,PLGF blood drawing and color Doppler ultrasound PI and RI as soon as possible to screen for preeclampsia,prevent the occurrence of preeclampsia,reduce adverse pregnancy outcomes,and ensure the safety of mother and baby.