超声监测早孕期胚胎心率对妊娠结局的预测价值  

The predictive validity of fetal/embryonic heart monitoring during the first trimester in assessing the pregnancy outcomes

作　　者：龚晓萍 王冠杰 王海飞 孔晓晓 杨田[1] 刘晓瑞[1] 曹云云[1] Gong Xiaoping;Wang Guanjie;Wang Haifei;Kong Xiaoxiao;Yang Tian;Liu Xiaorui;Cao Yunyun(Department of Ultrasound,International Peace Maternal and Child Health,Affiliated to Shanghai Jiaotong University,Shanghai 200030,China)

机构地区：[1]上海交通大学医学院附属国际和平妇幼保健院超声科,200030

出　　处：《中华超声影像学杂志》2018年第11期982-985,共4页Chinese Journal of Ultrasonography

基　　金：上海市科委西医引导类项目(17411972700);上海交通大学医工交叉基金(YG2015QN32).

摘　　要：目的探讨孕8周前胎心率(fetalheartrate,FHR)≤120次/min胚胎的妊娠结局,并评估其预测胚胎妊娠结局的价值。方法回顾性分析孕8周前FHR≤120次/min胚胎的胎心率、孕妇临床病史及实验室检查等相关临床资料。结果①胎龄(gestationalage,GA)<8周,FHR≤120次/min死亡率为11.0%(110/998),FHR≤70次/min死亡率为100%(23/23)。②FHR71~80次/min死亡率为86.4%(19/22),81~90次/min死亡率为75.7%(28/37),91~100次/min死亡率为25.5%(14/55),101~110次/min死亡率为6.3%(13/208),111~120次/min死亡率为2.0%(13/653)。③ROC分析结果显示,以FHR为94次/min预测胚胎妊娠生存结局,曲线下面积为0.906(P<0.0001),敏感性和特异性分别为97.86%、71.43%。结论超声监测孕8周前胎心率,可为临床预测胚胎不良妊娠结局提供可靠依据;FHR94次/min是妊娠结局最佳预测值。Objective To explore the pregnancy outcomes in women whose fetal/embryonic heart rate(FHR)were below 120 beats per minute(bpm)before 8 weeks pregnancy and determine the predictive value of FHR in pregnancy outcome.Methods The laboratory examinations,clinical data and clinical history of the pregnant women whose FHR were below 120 bpm before 8 weeks pregnancy were retrospectively analyzed.Results When gestational age(GA)was less than 8 weeks,pregnancy loss was observed in 11.0%(110/998) cases with an FHR less than or equal to 120 bpm,and pregnancy loss occurred in all the cases (23/23) with an FHR less than or equal to 70 bpm.The proportions of first trimester loss were 86.4%(19/22) for pregnancies with an FHR of 71-80 bpm,75.7%(28/37) for pregnancies with an FHR of 81-90 bpm,25.5%(14/55) for pregnancies with an FHR of 91-100 bpm, 6.3%(13/208 )for pregnancies with an FHR of 101-110 bpm,and 2.0%(13/653) for pregnancies with an FHR of 111-120 bpm.ROC analysis showed that the best cut-off value to predict adverse pregnancy outcomes was an FHR of 94bpm.The area under the ROC curve was 0.906(P<0.0001) and its sensitivity and specificity values were 97.86% and 71.43% respectively.Conclusions Fetal/embryonic heart monitoring before 8-weeks pregnancy can be an effective predictor for early pregnancy outcome.The best cut-off value to predict adverse pregnancy outcomes is an FHR of 94 bpm.

关 键 词：超声检查 心率 胎儿 孕早期 妊娠生存结局 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]