超声检测胚胎心率减慢预测早孕期胚胎妊娠生存结局的研究价值  

Research value of ultrasound detection of embryo heart rate slowdown in predicting the pregnancy survival outcomes of early pregnancy

作　　者：杨晔洁 张惠 王旭 YANG Yejie;ZHANG Hui;WANG Xu(Maternal and Child Health Care Hospital of Songjiang District,Shanghai 201600,China)

机构地区：[1]上海市松江区妇幼保健院妇产科,上海201600

出　　处：《上海医药》2021年第20期34-37,共4页Shanghai Medical & Pharmaceutical Journal

基　　金：上海市松江区科学技术攻关项目(19SJKJ66133)。

摘　　要：目的:探讨孕8周前胚胎心率(EHR)≤100次/min的妊娠生存结局,并评估其预测胚胎流产率的价值。方法:收集2019年2月至2020年12月在门诊进行产前检查的早期妊娠孕妇800例进行超声检测,将孕8周前EHR≤100次/min的112例孕妇纳入研究,分析胚胎妊娠生存结局。结果:胚胎存活28例,流产84例。胎龄(GA)<8周,EHR≤73次/min,流产率为100%(27/27);EHR为74~90次/min时,流产率约93.47%(43/46);EHR为91~100次/min时,流产率约35.9%(14/39)。受试者工作曲线(ROC曲线)分析结果显示,以EHR为94次/min预测胚胎流产率,其曲线下面积(AUC)为0.918(P<0.0001),曲线下面积95%可信区间(confidence interval,CI)为0.850~0.961,敏感性及特异性分别为95.24%和82.14%。结论:妊娠早期(孕8周以前),超声检测胚胎心率具有重要的临床意义,可以为临床预测胚胎妊娠生存结局提供可靠的依据;早孕期EHR越慢,胚胎流产率越高。Objective:To explore the pregnancy survival outcomes of embryonic heart rate(EHR)that were below 100 beats per minute(bpm)before 8 weeks gestational age(GA)and to evaluate the value in predicting the rate of embryo abortion.Methods:Eight hundred pregnant women with early pregnancy who underwent prenatal examination in the clinic from February 2019 to December 2020 were examined by ultrasonography,112 pregnant women with EHR≤100 times/min before 8 weeks of pregnancy were included in the study to analyze the survival outcome of embryonic pregnancy.Results:There were twenty-eight cases of embryos survival and 84 cases of abortions.GA was less than 8 weeks,EHR was less than 73 times/min,and the abortion rate was 100%(27/27);when EHR was 74~90 times/min,the abortion rate was about 93.47%(43/46);when EHR was 91~100 times/min,the abortion rate was about 35.9%(14/39).The results of receiver operating curve(ROC curve)analysis showed that the area under the curve(AUC)was 0.918(P<0.0001),the 95% confidence interval(CI)of the area under the curve was 0.850~0.961,and the sensitivity and specificity were 95.24% and 82.14%,respectively.Conclusion:In the early stage of pregnancy(before 8 weeks of pregnancy),ultrasonic detection of embryonic heart rate has important clinical significance,and it can provide a reliable basis for predicting the survival outcome of embryonic pregnancy;the slower the fetal heart rate in early pregnancy,the higher the embryo abortion rate.

关 键 词：流产 早孕期 胚胎心率 超声检测 

分 类 号：R714[医药卫生—妇产科学]