Abstract:
Objective To investigate the combined diagnostic value of transvaginal ultrasound(TVS) and transabdominal ultrasound(TAS) with β-human chorionic gonadotropin(β-HCG), progesterone, and estradiol(E
2) in early tubal pregnancy.
Methods A total of 117 patients with suspected tubal pregnancy who were admitted to Beijing Tongzhou Maternal and Child Health Care Hospital from January 2020 to January 2021 were enrolled. They underwent TVS and TAS imaging, and their levels of serum β-HCG, progesterone, and E
2 were measured.
Results Among 117 patients with suspected tubal pregnancy, 90 cases were clinically diagnosed with tubal pregnancy, with 27 normal pregnancy cases. The receiver operating characteristic(ROC) curve analysis showed that the area under the curve(AUC) of TVS, TAS examination and the combined examination was 0.715, 0.661 and 0.728, respectively. The tubal pregnancy group showed remarkably lower levels of serum β-HCG, progesterone and E
2 than the normal pregnancy group(
P<0.05). The AUC of serum β-HCG, progesterone, E
2 and their combination for the diagnosis of tubal pregnancy was 0.908, 0.922, 0.701 and 0.944, respectively. The positive detection rate of TVS and TAS were negatively correlated with the levels of serum β-HCG, progesterone and E
2(
P<0.05). The AUC of TVS and TAS examinations combined with serum β-HCG, progesterone and E
2 for the diagnosis of tubal pregnancy was 0.967(95% CI 0.940-0.994), with a sensitivity of 87.78% and a specificity of 96.30%, which were significantly higher than the diagnostic value of each examination, the diagnostic value of TAS combined with TVS and the combined diagnostic value of serum β-HCG, progesterone, and E
2.
Conclusions The detection positive rates of TVS and TAS in early tubal pregnancy were negatively correlated with serum β-HCG, progesterone and E
2 levels, and the combined diagnostic value is high, which can provide more comprehensive and reliable reference for clinical practice.