摘要
Abstract
Objective To investigate the predictive value of combining transvaginal ultrasound(TVS)parameters with serum β-human chorionic gonadotropin(β-hCG)and progesterone(P)levels at 6 weeks'gestation for subsequent embryonic demise before 12 weeks in embryos with confirmed viability.Methods A retrospective analysis was conducted on 400 pregnant women who underwent early pregnancy examination in the First Naval Hospital of PLA Southern Theater Command from January 2023 to June 2025.All included subjects had confirmed intrauterine viable pregnancy(presence of embryo and primitive cardiac pulsation)by TVS at 6 weeks'gestation.Based on the presence or absence of cardiac pulsation on follow-up ultrasound at 12 weeks,they were divided into continuing pregnancy group(n=320)and embryonic demise group(n=80).TVS parameters[mean sac diameter(MSD),yolk sac diameter(YSD)and morphology,crown-rump length(CRL)]and simultaneous serum β-hCG and P levels at 6 weeks were compared between two groups.The predictive efficacy of individual and combined indicators for subsequent embryonic demise was analyzed using receiver operating characteristic(ROC)curve.Results At 6 weeks'gestation,the MSD and CRL were significantly smaller,the proportion of abnormal YSD was significantly higher,and serum β-hCG and P levels were significantly lower in embryonic demise group compared to continuing pregnancy group(P<0.05).Multivariate Logistic regression analysis showed that smaller CRL(OR=2.252),abnormal YSD(OR=3.759),low β-hCG level(OR=1.984),and low P level(OR=1.716)were independent risk factors for subsequent embryonic demise(P<0.05).ROC curve analysis revealed that the combined predictive model of TVS parameters,serum β-hCG,and P had an area under the curve of 0.921(95%CI:0.891-0.951),with a sensitivity of 86.3%and a specificity of 84.4%.Its predictive efficacy was superior to any single indicator.Conclusion Under the premise of confirmed embryonic viability at 6 weeks'gestation,comprehensive evaluation of CRL,YSD morphology,serum β-hCG,and P levels can effectively predict the risk of subsequent embryonic demise.This provides a basis for the early identification and stratified management of high-risk pregnancies in the first trimester.关键词
经阴道超声/β-人绒毛膜促性腺激素/孕酮/胚胎停育/早期预测Key words
Transvaginal ultrasound/β-Human chorionic gonadotropin/Progesterone/Embryonic demise/Early prediction分类
医药卫生
