血栓弹力图联合超声定量参数对胎儿生长受限的诊断效能研究.

Objective：To study the diagnostic efficacy of thromboelastography combined with ultrasound quantitative parameters on fetal growth restriction (FGR). Methods：A total of 50 cases of pregnant women with FGR admitted to Zhengzhou Maternal and Child Health Hospital from July 2021 to May 2023 were collected as the FGR group, and 50 pregnant women with normal fetal development in the same period and age group were selected as controls (the control group). The thromboelastogram indicators［maximum amplitude (MA), Angle, coagulation time (K), coagulation response time (R)］, umbilical and middle cerebral artery resistance index (RI), pulsation index (PI), end⁃systolic/end⁃diastolic peak value (S/D), cerebroplacental rate (CPR), weight, and abdominal circumference were compared between the two groups. Binary correlation and partial correlation analyses were performed to explore the correlation of thromboelastogram and ultrasound quantitative parameters with weight or abdominal circumference. The receiver operating characteristic (ROC) curve was performed to analyze the diagnostic value of thromboelastogram, ultrasound quantitative parameters, and the combined diagnosis of FGR. Results：Second-trimester, late-pregnancy, and before delivery the value of R and K were lower in the FGR group than in the control group, while the value of Angle and MA were higher (P < 0.05). The value of Umbilical artery S/D, umbilical artery PI, and umbilical artery RI in the FGR group were higher than those in the control group during the second⁃trimester, late-pregnancy, and before delivery, while the value of middle cerebral artery S/D, middle cerebral artery PI, middle cerebral artery RI, and CRP were lower than those in the control group (P < 0.05). The weight and abdominal circumference of the FGR group were lower than those of the control group in the second⁃trimester, late-pregnancy, and before delivery (P < 0.05). The binary correlation analysis showed that the thromboelastography and ultrasound quantitative parameters before delivery were more strongly correlated with both body weight and abdominal circumference (P < 0.05). Partial correlation analysis indicated that the value of R, K, middle cerebral artery RI, and CRP were positively correlated with body weight and abdominal circumference before delivery, while the value of Angle, MA, umbilical artery S/D, umbilical artery PI and umbilical artery RI remained negatively correlated with body weight and abdominal circumference (P < 0.05). The combined diagnosis of FGR by using thromboelastography and ultrasound quantitative parameters before delivery had a higher area under curve (AUC) than each single index (P < 0.05). Conclusion：The quantitative detection of thromboelastography combined with ultrasound in pregnant women with FGR can effectively monitor changes in coagulation function and fetal hemodynamics at different stages of pregnancy, which has a high value in the diagnosis of FGR. [ABSTRACT FROM AUTHOR]