UNASSIGNED: A retrospective cohort study of women with prior second-trimester pregnancy loss from January 2018 to December 2021 in Second Affiliated Hospital of Soochow University was performed. A total of 245 patients were included. Data from January 2018 to December 2019 were used to construct the model, and data from January 2020 to December 2021 were used to evaluate the model. Data on maternal demographic characteristics, MRI cervical measurements were extracted. The prediction model was constructed with independent variables determined by multivariate logistic regression analyses. Through receiver-operating characteristic (ROC) curve analysis, the predictive ability of the model for subsequent second trimester pregnancy loss in women was evaluated, and internal validation was performed through validation data.
UNASSIGNED: Thin cervix was observed in 77 (31.42%) women with prior second-trimester pregnancy loss, the mean longitudinal diameter of cervical canal on MRI was 11.76±2.75mm. The model reached a sensitivity of 80%, specificity of 75.90%, positive predictive value (PPV) of 55.80% and negative predictive value of 90.90%; ROC characteristics proved that the model was superior to any single parameter with an AUC of 0.826.
UNASSIGNED: Our observations showed that thin cervix and longitudinal diameter of cervical canal reliably predicted second trimester pregnancy loss. We developed and validated a nomogram model to predict the individual probability of second trimester pregnancy loss in the next pregnancy and hopefully improve the prediction and indication of interventions.
对2018年1月至2021年12月在苏州大学附属第二医院进行了一项回顾性队列研究。共纳入245例患者。2018年1月至2019年12月的数据用于构建模型,2020年1月至2021年12月的数据用于评估该模型。关于孕产妇人口统计学特征的数据,提取MRI宫颈测量值。预测模型是由多变量逻辑回归分析确定的独立变量构建的。通过接收器工作特性(ROC)曲线分析,评估了该模型对妇女随后的中期妊娠流产的预测能力,并通过验证数据进行内部验证。
■在77名(31.42%)妊娠中期流产的妇女中观察到宫颈薄,MRI上宫颈管的平均纵向直径为11.76±2.75mm。模型的灵敏度达到了80%,特异性75.90%,阳性预测值(PPV)为55.80%,阴性预测值为90.90%;ROC特征证明该模型优于任何单一参数,AUC为0.826。
■我们的观察表明,宫颈薄和宫颈管的纵向直径可靠地预测了孕中期妊娠丢失。我们开发并验证了一个列线图模型,以预测下一次妊娠中期妊娠流产的个体概率,并有望改善干预措施的预测和指征。