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中孕期非整倍体筛查结果与足月妊娠引产成功率的预测关系。

Relations between second-trimester aneuploidy screening results and prediction of labour induction success in term pregnancies.

机构信息

Department of Maternal Fetal Medicine, Health Sciences University, Etlik Zubeyde Hanim Maternity and Research Hospital, Ankara, Turkey.

Department of Obstetrics and Gynecology, Koc University School of Medicine, Istanbul, Turkey.

出版信息

J Obstet Gynaecol. 2021 May;41(4):527-531. doi: 10.1080/01443615.2020.1755619. Epub 2020 Jun 4.

Abstract

We aimed to assess whether the second-trimester maternal serum markers could be used for the prediction of labour induction success. This prospective study enrolled women planned labour induction at term. Women were assigned to one of two groups: vaginal prostaglandin or balloon dilatation. All patients were evaluated for Bishop score, maternal serum oestriol, human chorionic gonadotropin and progesterone at the time of second-aneuploidy screening. The total successful rate for induction of labour was 63.9% in both groups. Maternal serum oestriol multiple of median (MoM) values were significantly lower among the caesarean section group compared to the vaginal delivery group ( < .001). A MoM value of 0.74 for oestriol was associated with a sensitivity of 75.9%, specificity of 41.0%, a positive predictive value of 76.6% and a negative predictive value of 58.0% for a successful induction of labour. Oestriol had a good performance in the prediction of successful induction of labour at term.IMPACT STATEMENT Induction of labour is a common procedure undertaken whenever the benefits of prompt delivery outweigh the risks of expectant management. Previous studies have reported that a decreased progesterone/oestradiol ratio and increased maternal plasma oestriol levels are associated with successful labour. The results of this study showed that second-trimester oestriol multiple of median (MoM) value provide a significant contribution to the efforts of the prediction of successful induction of labour in term pregnancy, having a sensitivity of 69.8%, specificity of 92.4%, positive predictive value of 83.3% and negative predictive value of 82.5%. This finding can be used as an additional method for prediction of labour induction as well as multiparity and Bishop score. This adds new valuable data to the literature which could be used for systematic reviews and for implementing guidelines and protocols on labour induction.

摘要

我们旨在评估中期妊娠母血清标志物是否可用于预测引产的成功率。这项前瞻性研究纳入了计划在足月时引产的孕妇。将孕妇分为两组:阴道前列腺素或球囊扩张。所有患者在进行第二非整倍体筛查时均评估了 Bishop 评分、母血清雌三醇、人绒毛膜促性腺激素和孕酮。两组的引产总成功率均为 63.9%。与阴道分娩组相比,剖宫产组母血清雌三醇中位数倍数(MoM)值明显较低(<0.001)。雌三醇 MoM 值为 0.74 时,其预测引产成功的灵敏度为 75.9%,特异度为 41.0%,阳性预测值为 76.6%,阴性预测值为 58.0%。雌三醇在预测足月引产成功方面具有良好的表现。

本研究表明,中期妊娠雌三醇 MoM 值对预测足月妊娠引产成功有显著贡献,其灵敏度为 69.8%,特异度为 92.4%,阳性预测值为 83.3%,阴性预测值为 82.5%。这一发现可作为预测引产成功率的附加方法,也可用于多胎妊娠和 Bishop 评分。这为文献增添了新的有价值的数据,可用于系统评价,并为引产的实施指南和方案提供依据。

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