Abstract:Objective To investigate the predictive efficacy of combined detection of α1-antitrypsin (AAT),D-dimer(D-D) and homocysteine (Hcy) on pregnancy outcome in patients with threatened abortion.Methods The clinical data of 100 patients with threatened abortion who received tocolysis treatment in Pingxiang People's Hospital from June 2021 to January 2023 were retrospectively analyzed.According to the pregnancy outcome,they were divided into tocolysis failure group and tocolysis success group.The baseline data,serum AAT,D-D and Hcy levels in early pregnancy were compared between the two groups.Logistic regression analysis was used to explore the relationship between serum AAT,D-D and Hcy levels and pregnancy outcome in patients with threatened abortion.The ROC curve was used to analyze the predictive efficacy of serum AAT,D-D and Hcy levels on pregnancy outcome in patients with threatened abortion.Results Among the 100 patients with threatened abortion,20 cases (20.00%)had inevitable abortion and 15 cases (15.00%)had delayed abortion after tocolytic therapy,which were included in the tocolysis failure group,65 cases (65.00%)continued pregnancy to successful delivery and were included in the tocolysis success group.The level of serum AAT in the tocolysis failure group was lower than that in the tocolysis success group before the treatment,and the levels of D-D and Hcy were higher than those in the tocolysis success group,and the differences were statistically significant (P<0.05).Logistic regression analysis showed that higher serum AAT (β=-1.769,OR=0.170,95%CI=0.068-0.429) was a independent protective factor for pregnancy outcome in patients with threatened abortion,and higher D-D (β=2.504,OR=12.229,95%CI=4.037-37.045) and Hcy(β=0.612,OR=1.844,95%CI=1.212-2.804) were independent risk factors for pregnancy outcome in patients with threatened abortion(P<0.05).The ROC curve showed that serum AAT,D-D and Hcy levels could be used to predict the pregnancy outcome of patients with threatened abortion.The combined prediction of the three had the highest prediction efficiency,and the AUC was 0.898,the sensitivity and specificity were 88.57% and 78.46%,respectively.Conclusion The levels of serum AAT,D-D and Hcy are related to the pregnancy outcome of patients with threatened abortion.If there is low expression of AAT,high expression of D-D and Hcy in clinical practice,threatened abortion should be alerted.
Zhao HQ,He W,Yang Z.A pairwise and network meta-analysis comparing the efficacy and safety of progestogens in threatened abortion[J].Int J Gynaecol Obstet,2022,156(3):383-393.
[2]
Feng JL,Li QF,Zhang XH,et al.Acupuncture Treatment for Threatened Abortion[J].Med Acupunct,2023,35(1):43-47.
[3]
Salas A,Gastón B,Barrenetxea J,et al.Predictive value of hyperglycosylated human chorionic gonadotropin for pregnancy outcomes in threatened abortion in first-trimester viable pregnancies[J].An Sist Sanit Navar,2021,44(1):23-31.
[4]
Zeng PF,Zhou H,Guo P,et al.Efficacy and safety of traditional Chinese herbal medicine in the treatment of threatened abortion:A protocol for systematic review and meta-analysis[J].Medicine(Baltimore),2021,100(5):2328-2338.
[5]
Chen XL,Tao C,Wang JY,et al.Meta-analysis of therapeutic efficacy and effects of integrated traditional Chinese and Western medicine on coagulation and fibrinolysis system in patients with threatened abortion and polycystic ovary syndrome[J].Am J Transl Res,2022,14(5):2768-2778.
Zhang LJ,Fu HN,Wei T.MTHFR gene polymorphism and homocysteine levels in spontaneous abortion of pregnant women[J].Am J Transl Res,2021,13(6):7083-7088.
[10]
谢幸,苟文丽.妇产科学[M].8 版.北京:人民卫生出版社,2013:48-50.
[11]
Khan RI,Taimoor A,Nazir A,et al.Association Of Subchorionic Hematoma With Preterm Labour In Patients With Threatened Abortion[J].J Ayub Med Coll Abbottabad,2021,33(3):451-455.
Dong LB,Han WZ,Xiong GP,et al.Prediction value of plasma D-dimer level changes on venous thromboembolism during pregnancy[J].J Matern Fetal Neonatal Med,2022,35(25):7486-7490.