Predictive Value Of Combined Detection Of Serum Progesterone And Estradiolin Early Intrauterine Pregnancyoutcome

Objective:Through the dynamic detection of serum P and E₂ levels in women of different gestational ages in early pregnancy,and the analysis of the correlation between the levels of P and E2 in different gestational weeks and pregnancy outcome,to explore the predictive value of combined detection of serum P and E₂ on the outcome of early intrauterine pregnancy,and to assist the clinical early evaluation of pregnancy outcome and the establishment of diagnosis and treatment programs,so as to reduce the occurrence of adverse pregnancy related complications.as early as possible,so as to reduce the occurrence of adverse pregnancy related complication.Methods:Select 172 early-pregnant women?97 cases in the normal pregnancy group and 75 cases in the embryo termination group?from Qingdao Women and Children's Hospital.According to the production and secretion sources of P and E2 in different gestational weeks,each group was divided into 4-6⁺66 weeks group,7-8⁺66 weeks group and 9-11⁺66 weeks group.Analyze the changes of serum P and E₂ with the gestational week in the normal pregnancy group,compare the differences of serum P and E₂ levels in women with different pregnancy outcomes in the same gestational week group,and use the receiver operating characteristic curve?ROC curve?to analyze the P and E₂ levels.And combined testing for predictive value of pregnancy outcomes.Results:1.The P level in the normal pregnancy group decreased briefly at 7-8⁺66 weeks,and there was no significant difference in the P level among the 3 gestational week groups?P>0.05?.The E₂ level increased with the increase of the gestational week,and E₂ The difference between 4 to 6⁺66 weeks and 7 to 8⁺66 weeks was statistically significant?P<0.05?,and the difference between 7 to 8⁺66 weeks and 9 to 11⁺66 weeks was not statistically significant?P>0.05?.2.At 4 to 6+6 weeks of pregnancy,there was a statistically significant difference in serum P and E2 levels between the normal pregnancy group and the embryo termination group?P<0.05?.The cut-off values were 60.04 nmol/L and 1233.00 pmol/L,respectively.The sensitivity of single P test,single E2 test and combined P and E2 test to predict the outcome of early intrauterine pregnancy was 44.00%,72.00%and 80.00%,the specificity was 83.87%,83.87%and 67.74%,the positive predictive value was 68.75%,78.26%and66.67%,the negative predictive value was 68.75%,78.26%and 66.67%,respectively.3.At 7-8+6 weeks of pregnancy,there was no significant difference in serum P levels between different pregnancy outcome groups?P>0.05?,the difference in E₂ levels was statistically significant?P<0.05?.The cut-off values of the two items were 40.48 nmol/L and 1589.00 pmol/L.The sensitivity of three methods to predict the outcome of early intrauterine pregnancy was 28.00%,36.00%,68.00%,the specificity was 97.50%,77.50%,92.50%,the positive predictive value was 68.42%,65.96%,82.22%,the NPV was 87.50%,50.00%,85.00%,respectively.4.At 9 to 11⁺66 weeks of pregnancy,the two groups There was a statistically significant difference in P and E₂ between the poor serums?P<0.05?,with cut-off values of 57.38 nmol/L and 1372.00 pmol/L,respectively.The sensitivity of the three methods was 80.00%,60.00%,88.00%,the specificity was 92.31%,88.46%,92.31%,the positive predictive value was 82.76%,69.70%,88.89%,the negative predictive value was 90.91%,83.33%,91.67%,respectively.Conclusion:1.In the early stage of intrauterine pregnancy,the level of P and E2 had been decreased before the fetal termination.2.In normal early intrauterine pregnancy,there was no correlation between P level and gestational age,and E₂ level continued to increase with gestational age.3.In the prediction of pregnancy outcome,the gestational weeks are different,and the predictive value of three detection methods is also different:at 4-6⁺66 weeks and 9-11⁺⁶weeks of gestation,single detection and combined detection can be used to predict pregnancy outcome,at 7-8⁺66 weeks of gestation,single P detection can not be used to evaluate pregnancy outcome.4.Among the three gestational weeks,the sensitivity of combined detection of P and E₂to predict the outcome of early intrauterine pregnancy was the highest.In terms of specificity,SP detected by P alone or E₂ was the highest at 4-6⁺66 weeks of gestation,SP detected by P alone was the highest at 7-8⁺66 weeks of gestation,and SP detected by P alone or jointly was the highest at 9-11⁺66 weeks of gestation.