目的:分析和总结不同超声方法诊断受孕残留产物准确性的证据。
方法:我们搜索了OvidSp,护理和相关健康文献累积登记册(CINAHL)和EBSCO,包括CORE在内的灰色文献,TRIP,NDLTD全球ETD搜索,BMJ最佳实践,PubMed,GreyLit报告网站(http://www.greylit.org/),Cochrane中央对照试验登记册(CENTRAL)和Google学者(https://scholar。google.com/).
方法:我们纳入了前瞻性和回顾性横断面或队列研究,评估了所有胎龄RPOC的超声发现(RPOC治疗前)和组织病理学结果。
方法:我们使用COVIDENCE进行研究的数据提取和质量评估。荟萃分析使用RevMan5.4(森林地块)进行,MetaDTA版本2.01和Meta-DiSc2.0在线软件。
结果:总计,11项研究符合数据提取和荟萃分析的条件。这11项研究的参与者总数为1567人。在这些中,包括九项研究来测试回声质量的准确性,4项研究分析了子宫内膜厚度,5项研究分析了彩色多普勒血流.我们发现回声团的灵敏度最高,预测受孕保留产物的特异性和诊断赔率比(DOR)。敏感性,特异性和DOR为0.915(95%CI0.844-0.955),0.843(95%CI0.615-0.947)和57.787(95%CI15.171-220.112),分别。将子宫内膜厚度的诊断阈值设定为10mm,特异性和DOR为0.667(95%CI0.072-0.981),0.866(95%CI0.375-0.986)和12.927(95%CI0.23-726.582)。敏感性,彩色多普勒血流的特异性和DOR为0.850(0.756-0.913的95%CI),0.406(95%CI0.198-0.655)和3.893(95%CI1.005-15.081)。
结论:我们的综述得出结论,回声质量是任何妊娠事件后保留的受孕产物的最敏感和特异性预测指标。我们综述的最重要的局限性是所纳入研究的设计导致了显著的统计异质性。
This study aimed to analyze and summarize the evidence on the accuracy of different ultrasound methods in the diagnosis of retained products of conception.
We searched Ovid SP, the Cumulative Register to Nursing & Allied Health Literature, EBSCO, and grey literature including Core, Trip, Networked Digital Library of Theses and Dissertations Global ETD search, BMJ Best Practice, PubMed, GreyLit report website (http://www.greylit.org/), Cochrane Central Register of Controlled Trials, and Google scholar (https://scholar.google.com/).
We included prospective and retrospective cross-sectional or Cohort studies that evaluated both ultrasound findings (before management of retained products of conception) and histopathologic results of retained products of conception at all gestational ages.
We used Covidence for data extraction from the studies and quality assessment. The meta-analysis was performed using RevMan 5.4 (forest plot), MetaDTA version 2.01, and Meta-DiSc 2.0 online software.
In total, 11 studies were eligible for data extraction and meta-analysis. The total number of study participants from these 11 studies were 1567. Of these, 9 studies were included to test the accuracy of an echogenic mass, 4 studies analyzed the accuracy of endometrial thickness, and 5 studies analyzed the accuracy of color Doppler flow to predict retained products of conception. We found that echogenic mass had the highest sensitivity, specificity, and diagnostic odds ratio for predicting retained products of conception. The sensitivity, specificity, and diagnostic odds ratio were 0.915 (95% confidence interval, 0.844-0.955), 0.843 (95% confidence interval, 0.615-0.947), and 57.787 (95% confidence interval, 15.171-220.112), respectively. The diagnostic threshold for endometrial thickness was set at 10 mm with a sensitivity, specificity, and diagnostic odds ratio of 0.667 (95% confidence interval, 0.072-0.981), 0.866 (95% confidence interval, 0.375-0.986), and 12.927 (95% confidence interval, 0.23-726.582). The sensitivity, specificity, and diagnostic odds ratio of color Doppler flow were 0.850 (95% confidence interval, 0.756-0.913), 0.406 (95% confidence interval, 0.198-0.655), and 3.893 (95% confidence interval, 1.005-15.081).
Our review concluded that an echogenic mass is the most sensitive and specific predictor of retained products of conception after any pregnancy event. The most important limitation of our review is that the design of the studies included led to significant statistical heterogeneity.