Application of transvaginal color doppler ultrasound in early diagnosis of threatened abortion and its correlation with serum levels of β - hCG and CA125.

OBJECTIVE

To explore the value of transvaginal color Doppler ultrasound (TVCDS) combined with serum β-human chorionic gonadotropin (β-HCG) and carbohydrate antigen-125 (CA125) in diagnosing threatened abortion and predicting adverse pregnancy outcomes.

METHODS

A retrospective case-control study included 98 pregnant women with threatened abortion (observation group) and 100 normal pregnant women (control group). Serum indicators, corpus luteum pulsatility index (PI) and resistance index (RI) were compared. Correlations and combined predictive efficacy were analyzed using multivariate logistic regression and receiver operating characteristic (ROC) curves.

RESULTS

TVCDS showed 92.86% sensitivity, 100% specificity and 0.912 AUC in diagnosing threatened abortion. The observation group had higher corpus luteum PI, RI and CA125, but lower β-HCG than the control group (all P<0.001). Corpus luteum PI and RI were negatively correlated with β-HCG (r=-0.401, -0.465) and positively with CA125 (r=0.511, 0.492, all P<0.01). Multivariate logistic regression identified PI, β-HCG, and CA125 as independent predictors of failed pregnancy preservation. The combined predictor (predicted probability from the regression model) yielded an AUC of 0.931, superior to any single indicator (P<0.001).

CONCLUSION

TVCDS combined with serum β-HCG and CA125 improves the efficacy in diagnosing threatened abortion and predicting adverse pregnancy outcomes. The multivariate model provides a reliable tool for individual risk assessment.