超声检测孕早期子宫下段妊娠囊旁血肿对孕妇血清游离β-HCG 和 PAPP-A 水平的影响。
Effect of subchorionic hematoma on first-trimester maternal serum free β-hCG and PAPP-A levels.
机构信息
Etlik Zübeyde Hanım Maternity and Women's Health Teaching and Research Hospital Department of Obstetrics and Gynecology Ankara Turkey Etlik Zübeyde Hanım Maternity and Women's Health Teaching and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey.
Bingöl State Hospital Department of Obstetrics and Gynecology Bingöl Turkey Bingöl State Hospital, Department of Obstetrics and Gynecology, Bingöl, Turkey.
出版信息
Rev Bras Ginecol Obstet. 2024 Jul 26;46. doi: 10.61622/rbgo/2024rbgo66. eCollection 2024.
OBJECTIVE
This study aimed to investigate the effects of the presence of subchorionic hematoma (SH) in early pregnancies with threatened miscarriage (TM) on levels of first-trimester maternal serum markers, pregnancy-associated plasma protein-A (PAPP-A), and free β-human chorionic gonadotropin (β-hCG) levels.
METHODS
The data of TM cases with SH in the first trimester between 2015 and 2021 were evaluated retrospectively. The data of age and gestational age-matched TM cases without SH were also assessed to constitute a control group. Demographic characteristics, obstetric histories, ultrasonographic findings, and free β-hCG and PAPP-A levels of the groups were compared.
RESULTS
There were 119 cases in the study group and 153 cases in the control group. The median vertical and longitudinal lengths of the SH were 31 mm and 16 mm. The median age of both groups was similar (p=0.422). The MoM value of PAPP-A was 0.088 (.93) in the study group and 0.9 (0.63) in the control group (p=0.519). Similarly, the MoM value of free β-hCG was 1.04 (0.78) in the study group and 0.99 (0.86) in the control group (p=0.66). No significant relationship was found in the multivariate analysis between free β-hCG MoM, PAPP-A MoM, age, gravida, and vertical and longitudinal lengths of the hematoma (p>0.05).
CONCLUSION
The level of PAPP-A and free β-hCG were not affected by the SH. Therefore, these markers can be used reliably in TM cases with SH for the first-trimester fetal aneuploidy screening test.
目的
本研究旨在探讨早期妊娠伴难免流产（threatened miscarriage，TM）时存在的绒毛膜下血肿（subchorionic hematoma，SH）对妊娠相关血浆蛋白-A（pregnancy-associated plasma protein-A，PAPP-A）和游离β-人绒毛膜促性腺激素（free β-human chorionic gonadotropin，β-hCG）水平的影响。
方法
回顾性评估了 2015 年至 2021 年期间在早期妊娠时存在 SH 的 TM 病例的数据。还评估了年龄和孕龄匹配的无 SH 的 TM 病例的数据，以构成对照组。比较了两组的人口统计学特征、产科史、超声检查结果以及游离β-hCG 和 PAPP-A 水平。
结果
研究组有 119 例，对照组有 153 例。SH 的垂直和纵向长度中位数分别为 31mm 和 16mm。两组的中位年龄相似（p=0.422）。研究组 PAPP-A 的 MoM 值为 0.088（0.93），对照组为 0.9（0.63）（p=0.519）。同样，研究组游离β-hCG 的 MoM 值为 1.04（0.78），对照组为 0.99（0.86）（p=0.66）。多元分析显示，游离β-hCG MoM、PAPP-A MoM、年龄、孕次、血肿的垂直和纵向长度与两者之间均无显著关系（p>0.05）。
结论
SH 并不影响 PAPP-A 和游离β-hCG 的水平。因此，这些标志物可在 SH 存在的 TM 病例中可靠地用于早孕期胎儿非整倍体筛查试验。
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