Evaluation Of The Predictive Value Of Transvaginal Two-Dimensional And Three-Dimensional Ultrasound Detection Of Corpus Luteum Blood Flow In Early Pregnancy Outcomes

ObjectiveThe aim of this study is to evaluate the predictive value of transvaginal two-dimensional color Doppler blood flow imaging and three-dimensional ultrasound power Doppler blood flow imaging for early miscarriage,in order to detect pregnant women with early miscarriage tendencies and reduce the incidence of early miscarriage.Methods181 first-time pregnant women were included as the subjects of this study,and they were divided into a normal pregnancy group(150 cases)and a pregnancy termination group(31 cases)based on their pregnancy outcomes.All pregnant women underwent transvaginal two-dimensional color Doppler blood flow imaging and three-dimensional ultrasound power Doppler blood flow imaging to measure corpus luteum parameters,mainly including mean diameter(Diameter,D),volume(V),pulsatility index(PI),resistance index(RI),flow index(FI)Vascular formation index(VI)and vascular flow index(VFI).Compare the differences in luteal parameters between two groups of pregnant women,and then analyze the effectiveness of these luteal parameters in predicting early miscarriage.Results(1)Comparison of demography characteristics: there was no significant difference between the two groups in age,pregnancy,smoking history,drinking history and body mass index(P>0.05).(2)Comparison of corpus luteum parameters measured by transvaginal two-dimensional color Doppler flow imaging: The average diameter,RI,and PI values of the corpus luteum in normal pregnant women were(22.26 ± 1.65)mm,(0.51 ± 0.86),and(0.65 ± 0.11),respectively;The average luteal diameter,RI,and PI values of pregnant women in the pregnancy termination group were(14.19 ± 1.80)mm,(0.60 ± 0.13)mm,and(0.86 ± 0.08)respectively;The average corpus luteum diameter of pregnant women in the normal pregnancy group was higher than that in the pregnancy termination group,but the RI and PI values of pregnant women in the normal pregnancy group were lower than those in the pregnancy termination group,and the above differences were statistically significant(P<0.05).(3)Comparison of luteal parameters measured by transvaginal three-dimensional ultrasound power Doppler flow imaging: The luteal volume,VI,FI,and VFI values of pregnant women in the normal pregnancy group were(6.19 ± 1.11)mm~3,(25.74 ± 5.88),(46.31 ± 13.45),and(14.57 ± 2.38),respectively;The luteal volume,VI,FI,and VFI values of pregnant women in the pregnancy termination group were(3.85 ± 0.92)mm~3,(16.04 ± 4.10),(31.52 ± 3.84),and(7.42 ± 2.18),respectively;The luteal volume,VI,FI,and VFI values of pregnant women in the normal pregnancy group were higher than those in the pregnancy termination group,with statistically significant differences(P<0.05).(4)The predictive efficacy of transvaginal two-dimensional color Doppler flow imaging in measuring corpus luteum parameters: The average diameter of the corpus luteum,RI,and PI predicted Area Under Curve(AUC)for early miscarriage,which were 0.771,0.847,and 0.794,respectively.The predicted critical values were 16.89 mm,0.655,and 0.765,respectively.The sensitivity was 71.0%,74.2%,and 74.2%,and the specificity was 99.3%,90.3%,and85.3%,respectively.(5)The predictive efficacy of transvaginal three-dimensional ultrasound power Doppler flow imaging in measuring corpus luteum parameters: The AUC values of corpus luteum volume,VI,FI,and VFI for predicting early miscarriage were 0.729,0.736,0.901,and 0.640,respectively.The critical predictive values were 3.505mm~3,17.505,30.715,and 18.875,respectively.The sensitivity was87.1%,77.4%,87.1%,and 64.5%,and the specificity was 70.0%,73.3%,88.0%,and 98.0%,respectively.(6)The efficacy of RI combined with FI in predicting early miscarriage: The AUC value of predicting early miscarriage using RI combined with FI was 0.886,with a sensitivity of 90.3% and a specificity of 76.7%.The efficacy of using RI combined with FI in predicting early miscarriage was slightly better than using RI alone(P<0.05),but not better than FI(P>0.05).Conclusions(1)The RI and PI values of pregnant women in the normal pregnancy group were lower than those in the termination group,but the average diameter,volume,VI,FI,and VFI of the corpus luteum were higher than those in the termination group,indicating a correlation between corpus luteum function and pregnancy outcomes;(2)The effectiveness of using RI combined with FI in predicting early miscarriage is slightly better than using RI alone,but not better than FI;(3)RI and FI have higher predictive power for early miscarriage,but FI has higher predictive power;Transvaginal three-dimensional ultrasound power Doppler blood flow imaging can be used as the first choice for assessing luteal function in clinical practice.