Odeh Marwan, Ophir Ella, Grinin Vitaly, Tendler Rene, Kais Mohamad, Bornstein Jacob
Department of Obstetrics and Gynecology, Western Galilee Hospital, Nahariya, Israel.
J Clin Ultrasound. 2012 Sep;40(7):389-93. doi: 10.1002/jcu.21957. Epub 2012 Jul 14.
To determine whether gestational sac volume (GSV) or amniotic sac volume (ASV) and/or the difference between them can predict abortion in women with first-trimester threatened abortion.
Ninety patients between 6 and 12 weeks of gestation presenting with vaginal bleeding were studied. Seventy-six delivered after 24 weeks of gestation (group A) and 14 aborted before 20 weeks of gestation (group B). All patients had a singleton viable pregnancy demonstrated by transvaginal ultrasound. Gestational sac and amniotic sac volumes were measured in all the patients using three-dimensional transvaginal ultrasound with Virtual Organ Computer-aided Analysis software, and the gestational sac volume - amniotic sac volume (GSV - ASV) was calculated.
The groups did not differ in terms of age, parity, number of previous abortions, or term deliveries. The GSV (group A: mean 32.0 ± 27.7 cm(3) ; group B: 26.7 ± 29.1 cm(3) ) and the ASV (group A: 21.1 ± 25.5 cm(3) ; group B: 20.6 ± 26.0 cm(3) ) were not statistically different, while the GSV - ASV was significantly smaller in group B (aborting before week 20) (group A: 10.9 ± 10.9 cm(3) ; group B: 6.1 ± 8.6 cm(3) ; p < 0.05). Using receiver operator curves, the area under the curve for predicting normal pregnancy outcome of the GSV - ASV measurement was 0.654. When the GSV - ASV was 1.8 cm(3) or less, abortion was predicted with 84% sensitivity and 43% specificity.
The measurement of the GSV and the ASV are not good predictors of abortion in patients with first-trimester vaginal bleeding, whereas the use of the GSV - ASV may be helpful in predicting the outcome of pregnancy.
确定妊娠囊体积（GSV）或羊膜囊体积（ASV）以及/或者它们之间的差值能否预测孕早期先兆流产女性的流产情况。
对90例妊娠6至12周出现阴道流血的患者进行研究。76例在妊娠24周后分娩（A组），14例在妊娠20周前流产（B组）。所有患者经阴道超声检查均显示为单胎存活妊娠。使用带有虚拟器官计算机辅助分析软件的三维经阴道超声对所有患者测量妊娠囊和羊膜囊体积，并计算妊娠囊体积 - 羊膜囊体积（GSV - ASV）。
两组在年龄、产次、既往流产次数或足月分娩次数方面无差异。妊娠囊体积（A组：平均32.0±27.7 cm³；B组：26.7±29.1 cm³）和羊膜囊体积（A组：21.1±25.5 cm³；B组：20.6±26.0 cm³）无统计学差异，而B组（妊娠20周前流产）的GSV - ASV显著更小（A组：10.9±10.9 cm³；B组：6.1±8.6 cm³；p<0.05）。采用受试者工作特征曲线分析，GSV - ASV测量预测正常妊娠结局的曲线下面积为0.654。当GSV - ASV为1.8 cm³或更小时，预测流产的敏感性为84%，特异性为43%。
妊娠囊体积和羊膜囊体积测量对孕早期阴道流血患者的流产情况不是良好的预测指标，而GSV - ASV的应用可能有助于预测妊娠结局。
