The Diagnostic Value Of Progesterone,β-hCG And FSH Combined With Endometrial Thickness In Early Ectopic Pregnancy

BackgroundEctopic pregnancy(EP)is an acute abdominal disease,usually caused by peripheral fallopian tube or intracavity inflammation,in which the fertilized egg is implanted outside the uterine cavity and ruptures.The clinical manifestations are usually acute abdominal pain,with a large amount of bleeding and a high risk of death.In recent years,with the relaxation of national population policy and the change of population concept,the incidence of EP has been increasing.Early clinical diagnosis is difficult in patients with no apparent symptoms prior to miscarriage or rupture.Routine use of early pregnancy test paper determination of urine HCG or serum β-hCG content can only determine whether pregnancy,not to determine the location of pregnancy.For threatened abortion,atypical early EP and early pregnancy in which the intrauterine sac has not yet been formed,it is difficult to distinguish in clinic and easily lead to misdiagnosis,thus the patient lost the best diagnosis and treatment period.With the improvement of medical level,some new technologies and joint diagnostic methods are gradually introduced into clinical practice.By analyzing the difference of serum progesterone(Prog),human chorionic gonadotropin(β-hCG),follicle-stimulating hormone(FSH)and transvaginal color Doppler ultrasonography in detecting endometrial thickness in assisting diagnosis of early ectopic pregnancy,this study provides theoretical basis for timely diagnosis and treatment of ectopic pregnancy.ObjectiveThe specificity,sensitivity and accuracy of single and combined detection of progesterone,β-hCG,follicle stimulating hormone(FSH)and endometrial thickness in ectopic pregnancy(EP)were observed.Analyze and evaluate its auxiliary diagnosticefficacy in ectopic pregnancy to provide help for clinical diagnosis and treatment of ectopic pregnancy.Methods1.Research objects: 66 patients with suspected ectopic pregnancy treated in the department of obstetrics and gynecology of Neixiang County People’s Hospital from January 2018 to January 2020 were selected,and 50 patients diagnosed as ectopic pregnancy through screening by the department of pathology of our hospital were included in EP group;50 normal pregnant women who underwent physical examination in our hospital during the same period were selected as the normal pregnancy group.In addition,50 pregnant women with threatened abortion in our hospital during the same period were selected as the threatened abortion group.All the subjects had the right to informed consent,and there was no statistical difference in age.2.Experimental methods: Serum samples of all subjects were collected and the levels of progesterone,LH,β-hCG,FSH and TSH were determined by electrochemical luminescence immunoassay.All subjects were examined by vaginal color ultrasound.Endometrial thickness and serum levels of Prog,LH,β-hCG,FSH and TSH were compared between groups.3.SPSS21.0 software was used for data analysis,and one-way analysis of variance was used for comparison between groups.The efficacy of each index in the diagnosis of early ectopic pregnancy was evaluated according to the ROC curve.Results1.Comparison of general data: there was no significant difference between the three groups in age and gestational age(P(29)0.05).2.Comparison of detection indexes among the three groups:(1)Compared with the normal pregnancy group,Prog,β-hCG and endometrial thickness were significantly reduced in the threatened abortion group and the ectopic pregnancy group(P(27)0.05),and the levels of serum FSH and LH were significantlyincreased(P(27)0.05).(2)Compared with the threatened abortion group,the serum β-hCG in the ectopic pregnancy group was significantly reduced(P(27)0.05).There was no significant difference in other indexes.(3)Compared with TSH,there was no significant difference among the three groups.3.Diagnostic efficacy evaluation of EP:(1)Serum β-hCG,Prog,FSH level and endometrial thickness all showed certain diagnostic efficacy in the diagnosis of ectopic pregnancy,and the AUROC values of these four subjects were 0.849,0.745,0.772 and 0.850,respectively.The AUROC of endometrial thickness was relatively high.(2)When endometrial thickness was measured in combination with any other indicator,endometrial thickness + β-hCG,endometrial thickness +Prog,and endometrial thickness +FSH were all superior to the single indicator of endometrial thickness.The AUROC was 0.906,0.884,and 0.898,respectively.The AUROC of endometrial thickness+β-hCG was the highest.(3)Endometrial thickness + β-hCG index combined with Prog and FSH index,the sensitivity of the four combined detection index was 94%,the heterosexuality was 95.8%,the accuracy was 90%,the positive predictive value was 95.1%,the negative predictive value was 97.4%,and the AUROC value was 0.948.ConclusionThe value of serum progesterone,β-hCG and FSH combined with endometrial thickness in the diagnosis of ectopic pregnancy is higher than that of single detection,so it has more extensive application value.