子宫动脉血流参数联合血清 PLGF、PAPP-A 预测早孕期不明原因 复发性流产孕妇妊娠结局的临床研究.

Objective: To explore the value of uterine arterial blood flow parameters combined with serum placental growth factor (PLGF) and pregnancy associated plasma protein-A (PAPP-A) in predicting the pregnancy outcome of pregnant women with unexplained recurrent spontaneous abortion (URSA) during early pregnancy. Methods : 103 pregnant women with URSA history who were admitted to our hospital from October 2021 to October 2022 were selected. Their pregnancy outcome at 28 weeks were tracked, and they were divided into normal pregnancy group (n=26) and abortion group (n=77) according to different pregnancy outcome. The uterine artery blood flow parameters [resistance index (RI), pulsation index (PI), peak systolic flow velocity/end-diastolic flow velocity (S/D)] and serum PLGF and PAPP-A levels were compared in the two groups. Multivariate Logistic regression model was used to analyze the influencing factors of pregnancy outcome of pregnant women with URSA during early pregnancy. The predictive value of uterine artery blood flow parameters combined with serum PLGF and PAPP-A for pregnancy outcome of pregnant women with URSA during early pregnancy was analyzed by receiver operating characteristic (ROC) curve. Results: The PI, RI and S/D in the abortion group were significantly higher than those in the normal pregnancy group (P＜0.05), while serum PLGF and PAPP-A levels were significantly lower than those in the normal pregnancy group (P＜0.05). Logistic regression model showed that the elevated PI, RI and S/D were the risk factor for pregnancy outcome of pregnant women with URSA during early pregnancy (P＜0.05), while the elevated serum PLGF and PAPP-A levels were the protective factor (P＜0.05). ROC analysis results showed that the combination of PI, RI, S/D, PLGF, and PAPP-A had the highest efficacy in predicting the pregnancy outcome of pregnant women with URSA during early pregnancy, and the area under the curve (AUC) of combined diagnosis was 0.913, which was significantly better than the diagnosis of each index alone. Conclusion: Uterine arterial blood flow parameters combined with serum PLGF and PAPP-A have high value in predicting pregnancy outcome of pregnant women with URSA during early pregnancy. [ABSTRACT FROM AUTHOR]