The Role of Blood Flow in Corpus Luteum Measured by Transvaginal Two-Dimensional and Three-Dimensional Ultrasound in the Prediction of Early Intrauterine Pregnancy Outcomes.

Huijuan Han,Yuqin Ma,Xinhai Mo,Yuqing Zhou,Bo Zhang

doi:10.3389/fphar.2019.00767

Huijuan Han, Yuqin Ma + Show 3 more

Open Access

https://doi.org/10.3389/fphar.2019.00767

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Abstract

Objective: The purpose of this study was to explore the application of transvaginal two-dimensional and three-dimensional power Doppler ultrasound in pregnancy corpus luteum to predict the final outcome of early intrauterine pregnancy. Methods: This is a prospective observational cohort study. Six hundred early intrauterine pregnant women in Shanghai Changning Maternity and Infant Health Hospital were selected as the research objects from January 2015 to December 2015. According to the follow-up of 12 weeks, these pregnant women were divided into the normal pregnancy group (group A, n = 512) and the terminational pregnancy group (group B, n = 88). They all underwent both transvaginal two-dimensional ultrasound and three-dimensional power Doppler ultrasound to obtain relevant parameters of corpus luteum, namely, the average diameter of the corpus luteum (D), resistance index (RI), pulsatility index (PI), corpus luteum volume (V), vascularization index (VI), blood flow index (FI), and vascularized blood flow index (VFI). Among them, V, VI, FI, and VFI were calculated with the virtual organ computer-aided analysis method. Receiver operator characteristic (ROC) curves were drawn. The corresponding diagnostic cut-off, sensitivity, and specificity were calculated and compared. Results: Compared with group A, the D, V, VI, FI, and VFI of corpus luteum in group B were statistically significant lower while RI and PI were statistically significant higher (P < 0.05). The diagnostic cut-off values in the prediction of early intrauterine pregnancy outcomes were D: 14.48, RI: 0.56, PI: 0.81, V: 3.89, VI: 21.48, FI: 38.99, and VFI: 10.21 respectively, and the sensitivity and specificity were D (99.2%, 67.0%), RI (98.9%, 65.0%), PI (78.4%, 89.1%), V (95.1%, 78.4%), VI (74.%, 90.9%), FI (91.8%, 90.9%), and VFI (93.9%, 87.5%) respectively. The area under the ROC curve of the combined index (RI + FI) was 0.963, which was not significantly higher compared with any single index, and both the sensitivity and specificity were 94.3%. Conclusion: Both transvaginal two-dimensional and three-dimensional ultrasonography are of high diagnostic value in predicting the early intrauterine pregnancy outcomes.

Highlights

Spontaneous abortion is one of the common complications during pregnancy, which may be attributed to embryonic factors, maternal factors, immune dysfunction, and environmental factors (Hassold et al, 2012)
The area under the Receiver operator characteristic (ROC) curve of the combined index (RI + flow index (FI)) was 0.963, which was not significantly higher compared with any single index, and both the sensitivity and specificity were 94.3%
Ultrasound Early Intrauterine Pregnancy Outcomes. Both transvaginal two-dimensional and three-dimensional ultrasonography are of high diagnostic value in predicting the early intrauterine pregnancy outcomes

Summary

Introduction

Spontaneous abortion is one of the common complications during pregnancy, which may be attributed to embryonic factors, maternal factors, immune dysfunction, and environmental factors (Hassold et al, 2012). Transvaginal three-dimensional ultrasound with power Doppler is a new emerging method of studying vascularization recently (Jokubkiene et al, 2012). It might better reflect vascular changes than two-dimensional color or power Doppler, because vascular changes in a whole organ can be assessed through blood flow velocity in one or a few vessels, and the results of quantitative analysis can be acquired by using the virtual organ computeraid analysis (VOCAL) software (Jarvela et al, 2003).

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