Value Of Yolk Sac Combined With Detection Of Serum Progesterone And CA₁₂₅ In The Prediction Of The Outcome Of Early Abortion

Objective:To investigate the clinical value of separation and combination of the ultrasonographic features of the yolk sac and serum levels of progesterone and carbohydrate antigen 125(CA125) for the pregnancy outcome of early abortion. Methods:Collecting 92 cases of pregnant women during the period of 5-8 weeks by transvaginal ultrasound examination from October 2013 to December 2014 in Shanxi Academy of Medical Sciences shanxi dayi hospital, observing and recording the characteristic of yolk sac and detecting serum levels of progesterone and CA125. Tracking to 28 weeks of pregnancy, the pregnant women will be divided into three groups according to pregnancy outcome :there are 32 cases of pregnant women in the early normal pregnancy group(control group), good pregnancy outcome of the threatened abortion group(good group), adverse pregnancy outcome of the threatened abortion group(adverse group). Analyzing and comparing the detection rate of yolk sac, yolk sac diameter, serum levels of progesterone and CA125 whether there is a statistically significant difference among three groups, and calculating the sensitivity, specificity and accuracy of the yolk sac, serum progesterone and serum CA125 in predicting early abortion alone or joint. Results:There are 30 cases of the yolk sac that can be observed clearly by transvaginal ultrasound examination in control group,the yolk sac was hyperechoic ring structure with a diameter of 3.2-6.3mm.There are 9 cases and 4 cases of the yolk sac that can not be observed in adverse group and good group.By Fisher’s test results, the presence or absence of yolk sac has a significant effect on pregnancy outcome(P=0.01), the diameters of yolk sac are(4.57±0.32mm),(4.84±0.64mm)and(4.93±2.06mm)in control group, good group and adverse group respectively,the difference of diameter of yolk sac was not significant among three groups statistically, P>0.05.Progesterone in the control group(29.88±1.41ng/ml)was significantly higher than that in the good group(23.94±1.84ng/ml) and the adverse group(14.93±2.17ng/ml),progesterone has a significant difference among three groups statistically(P <0.001), with P <17.10ng/ml as the critical value, the sensitivity,specificity and accuracy of predicting early abortion is 75.00%, 88.89%, 83.33% respectively.The level of CA125 in adverse group(43.33 ± 7.87U/ml) is significantly higher than that in control group(18.39 ± 1.09 U / ml)and good group(22.60 ± 2.54 U / ml)(P <0.001), with CA125 > 35.46 U/ml as the critical value, the sensitivity, specificity and accuracy of predicting early abortion is 58.33%, 88.89% and 76.67% respectively.The sensitivity,specificity and accuracy of yolk sac combined progesterone forecasting early abortion were 75.00%,77.78%,76.67%; The sensitivity,specificity and accuracy of yolk sac combined CA125 forecasting early abortion were 75.00%,77.78%,76.67%; The sensitivity,specificity and accuracy of progesterone combined CA125 forecasting early abortion were 75.00%,86.11%,81.67%; The sensitivity,specificity and accuracy of three indicators forecasting early abortion were 75.00%. Conclusion:1.Presence or absence of the yolk sac can be used as a judgment auxiliary index of early abortion, yolk yolk sac diameter not as criteria for early abortion and pregnancy outcome.2.Serum progesterone and CA125 are important indicators to predict early abortion.3. Progesterone has the highest accuracy predicting early abortion separately, followed by serum progesterone combined CA125.