A Meta-analysis Of Common Ultrasound Soft Markers In Prenatal Diagnosis

Objective:To analyze the common Ultrasound soft markers in prenatal ultrasound,evaluate the clinical significance of common Ultrasound soft markers in screening chromosomal abnormalities,provide evidence-based basis for prenatal screening chromosomal abnormalities,and improve clinicians' understanding of Ultrasound soft markers.Methods: To search Pub Med,Cochrane Library,EMBASE,CNKI,Wanfang Data,VIP Data,Chinese Biomedical website and other Datas,and to search and incorporate the relevant articles about the diagnostic value of ultrasound soft makers to chromosomal abnormality published in these Datas.The retrieval time was from the time when the database was established to may 2019.The included documents were screened in strict accordance with the inclusion criteria and exclusion criteria.The selected articles were extracted with basic information and data,and the quality of the final included documents was evaluated with QUADAS-2,using Meta-Disc1.4The software analyzed the data,combined Sen,Spe,+LR,-LR,make the SROC and calculated the area under the curve.Results: It was included 19 literatures,including 8 groups of CPC,12 groups of RPD,10 groups of EFI and 10 groups of EB.The results of Meta analysis showed that:(1)the Sen of CPC was 0.17,95% CI(0.14-0.20),the Spe was 0.98,95% CI(0.98-0.98),the +LR was 6.60,95%CI(2.46-17.74),the-LR was 0.74,95%CI(0.52-1.05).The DOR was 8.41,95%CI(2.31-30.62),the AUC was 0.996;(2)the Sen of EIF was 0.17,95% CI(0.14-0.20),the Spe was 0.96,95% CI(0.96-0.97),the+LR was 3.91,95% CI(1.80-8.52),the-LR was 0.84,95% CI(0.84-0.94).The DOR was 5.05,95% CI(2.26-11.25),the AUC was 0.978;(3)the Sen of RPD was 0.06,95% CI(0.05-0.07),the Sen was 0.98,95% CI(0.98-0.98),the +LR was 3.14,95%CI(0.78-12.6),the-LR was 0.95,95% CI(0.87-1.04).The DOR was 3.36,95% CI(0.79-14.34),the AUC was 0.931;(4)the Sen of EB was 0.10,95% CI(0.08-0.13),the Spe was 0.99,95% CI(0.99-0.99),the+LR was 10.56,95% CI(3.60-30.94),the-LR was 0.89,95% CI(0.78-1.01).The DOR was 11.77,and the AUC was 0.979.Conclusion: Ultrasound soft makers is indeed closely related to fetal chromosomal abnormalities.In our statistical results,choroid plexus cyst has thehighest diagnostic value and pyelosepsis has the lowest diagnostic value.However,the Sen of each ultrasound soft maker is higher,and the FP is also higher.The suggestion of chromosomal abnormalities is not significant when isolated soft makers appear,but the significance of chromosomal abnormalities is significantly increased when multiple soft makers appear at the same time.The use of ultrasound soft makers alone has a high FP for chromosome screening.We recommend using serological screening combined with ultrasound soft makers to provide personalized and more accurate prenatal consultation for pregnant women.