Clinical Application Of P And E2 In Ectopic Pregnancy

Background:Ectopic pregnancy(EP),as an acute abdomen syndrome occurring frequently in women of childbearing age in department of gynecology,is defined as the fertilized eggs planted outside of uterine cavity.Its incidence rate is about 1.5%-2.0%,which increases annually around the world,thus seriously threatening women's fertility and even life health.The diagnosis mainly depends on the results of surgical pathology and ultrasound.Although blood human chorinonic gonadotrophin(HCG)level is of certain value in the diagnosis and treatment of EP,it is not advisable for early patients as its diagnosis rate is low.Combined detection of serum indexes has become a hot spot,and has attempted to be used for the diagnosis of early EP.Objective:To investigate the application of serum progesterone(P)and estradiol(E2)levels in the diagnosis and treatment of EP,so as to provide reference for conservative diagnosis and treatment as well as clinical prognosis evaluation of EP.Method:A total of 150 patients with EP who were admitted in Department of Reproductive Medicine in our hospital from August 2014 to August 2016 and conformed to the criteria of conservative medication served as observation group,while another 150 people with normal pregnancy(NP)who underwent prenatal examinations in our hospital in corresponding period as control group.The clinical data of all enrolled study subjects were analyzed retrospectively.After admission,routine obstetric examinations were conducted,and the expression levels of serum P,E2 and?-HCG were detected on admission and 48 h after admission.As to patients with EP who succeeded and failed in abortion,peripheral venous blood was collected to detect the levels of serum P,E2 and?-HCG at post-pregnant 7 weeks.Observation group received clinical treatment,after which the changes of levels of serum P,E2and?-HCG were compared before admission and 48 h after admission,and the changes of serum P and E2 were observed between patients with EP who continued the pregnancy and those who terminated the pregnancy.All data were analyzed using SPSS19.0 software.Measurement data were expressed by mean±standard deviation(`x+s)and detected with t test,while enumeration data were expressed by ratio(%)and detected with x~2 test.P<0.05 was considered to be statistically significant.EPEPResults:1.Observation group was evidently higher in the rate of patients complicated with histories of pelvic infection,surgery of lower abdomen,EP and abortion than control group,and there was significant difference(P<0.05).2.When serum P was 5.96 ng/ml,the area under the curve(AUC)of receiver operating characteristic curve(ROC)was 0.869,and the sensitivity and specificity of P were 79.33%and 83.26%for the diagnosis of EP,respectively.When serum E2 was603.56 pmol/L,the AUC of ROC was 0.871,and the sensitivity and specificity of E2were 83.33%and 86.00%for the diagnosis of EP,respectively.When serum P was used in combination with E2,the AUC was 0.925,and the sensitivity and specificity of P combined with E2 were 92.67%and 78.67%for the diagnosis of EP,respectively.3.Observation group was markedly lower than control group in the expression levels of serum P,E2 and?-HCG on admission and 48 h after admission,and there were significant differences(P<0.05).The level of?-HCG showed an obvious increasing tendency 48 h after admission in control group,and there was significant difference when compared with that on admission(P<0.05).However,there was insignificant difference in the levels of P and E2 48 h after admission than those on admission in observation group(P>0.05).4.The analysis of relationship between pre-treatment initial serum P level and clinical efficacy showed that the clinical efficacy was 84.27%when P<10pmol/L,notably higher than the 55.17%and 40.63%when P was 10-15ng/L and>15ng/L on admission,and there were significant differences(x~2=10.495,P=0.001;2.604,P<0.05).However,the difference was insignificant between clinical efficacy when P was 10-15ng/L and>15ng/L(x~2=1.291,P=0.256).In observation group,104 patients succeeded in the abortion while 46 failed.The comparison of serum P and E2between patients who succeeded and whose who failed in abortion indicated that the levels of serum P and E2 were(7.09±4.56)ng/ml and(825.80±148.96)pmol/L in failed group,prominently higher than the(3.41±1.27)ng/ml and(682.23±152.44)pmol/L in succeeded group,respectively,and there were significant differences(t=7.617,5.356,all P<0.05).Conclusion:1.Serum P and E2 expression levels are helpful for the differential diagnosis of normal pregnancy and EP,which can be used as adjuvant indexes for the clinical diagnosis of EP.2.The expression of serum P can predict the clinical efficacy of EP.