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| Predictive value of the ultrasound examination results combined with the body mass index and the β-human chorionic gonadotropin level for the effect of the conservative treatment of patients with tubal pregnancy by methotrexate |
| The Third People's Hospital of Bengbu, Bengbu Medical University, Bengbu, Anhui Province, 233000 |
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Abstract To explore the predictive value of the ultrasound examination results combined with the body mass index (BMI) and the β-human chorionic gonadotropin (β-hCG) level for the effect of the conservative treatment of patients with tubal pregnancy by methotrexate. Methods: A total of 120 patients with tubal pregnancy treated in the hospital from January 2021 to April 2024 were selected in this study. All these patients were given conservative treatment by methotrexate. The effect of the conservative treatment was counted. The baseline data were compared among the patients with the different curative effect. The influencing factors of the effect of the conservative treatment of the tubal pregnancy of these patients were analyzed. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the ultrasound indicators combined with the BMI and the serum β-hCG level of the patients for the effect of their conservative treatment of tubal pregnancy. Results: After conservative treatment of 120 patients, there were 76 cases with the successful treatment (in group A) and 44 cases with the failed treatment (in group B). The BMI, the adnexal mass volume, the β-hCG level and the average blood flow velocity of the patients in group B were significantly higher than those of the patients in group A, and the blood flow resistance index of the patients in group B was significantly lower than that of the patients in group A (all P<0.05). Logistic regression analysis showed that the BMI, the β-hCG level, and the values of the ultrasound indicators, such as the average blood flow velocity, the adnexal mass volume and the resistance index of the patients with tubal pregnancy were the factors affecting their effect of the conservative treatment (all P<0.05). ROC curve analysis showed that the area under the curve (AUC) of the average blood flow velocity, the resistance index, the adnexal mass volume, the BMI or the β-hCG level of the patients for predicting the effect of their conservative treatment of the tubal pregnancy was 0.802, 0.800, 0.754, 0.701 or 0.672, respectively. The AUC of the combined the average blood flow velocity, the resistance index, the adnexal mass volume, the BMI and the β-hCG level of the patients for predicting their effect of their conservative treatment of the tubal pregnancy was 0.960, which had the best predictive value. Conclusion: The BMI, the serum β-hCG level and the ultrasound imaging indexes, such as the average blood flow velocity, the resistance index and adnexal mass volume of the patients with tubal pregnancy can be used to predict their conservative treatment effect by methotrexate, and the combined of which has the highest predictive efficiency, which can provide the references for the formulation and adjustment of the clinical treatment plan for the tubal pregnancy of the patients.
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