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| The value of ultrasound combined with the levels of serum creatine kinase, alpha-fetoprotein, and fetal free DNA of the pregnant women for diagnosing placenta previa and placental adhesions or placenta implantation |
| Yan 'an Hospital of Traditional Chinese Medicine, Shannxi Province, 716000 |
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Abstract To investigate value of ultrasound combined with the levels of serum creatine kinase(CK), alpha-fetoprotein(AFP), and fetal free DNA of the pregnant women for diagnosing placenta previa(PP) and placental adhesions(PA) or placenta implantation(PI). Methods: 118 pregnant women with PP were selected in research group from January 2017 to January 2019. Another 50 normal pregnant women were selected in control group during the same period. The levels of serum CK, AFP, and fetal free DNA of the women in the two groups were measured. The women with PA or PI were diagnosed by ultrasound examination and pathological examination. The ROC curve was used to analyze the values the levels of serum CK, AFP, and fetal free DNA, and the results of ultrasound examination for diagnosing PP and PA or PI. Results: The levels of serum CK and fetal free DNA of the women in the research group were significant higher than those of the women in the control group(P<0.05). The false negative rates of ultrasound for diagnosing PP and PI or PA were 29.4% and 27.8%, respectively. The sensitivity, the specificity, the false positive rate, and the false negative rate of the levels of serum CK, AFP and fetal free DNA for diagnosing PP and PI or PA were 73.1%-79.1%, 85.3%-91.2%, 21.2%-26.9%, and 8.8%-14.7%, respectively. The levels of serum CK, AFP, and fetal free DNA combined with ultrasound for diagnosing PP and PI or PA had not increased the specificity and the area under ROC curve, and also had not decreased the false positive rate(P>0.05). The sensitivity, the specificity, the false positive rate, and the false negative rate of the levels of serum CK, AFP, and fetal free DNA for diagnosing PP and PA were 73.1%79.1%, 83.3%-88.9%, 70.3%-73.5%, 26.5%-29.5%, and 11.1%-16.7%, respectively. The levels of serum CK, AFP, and fetal free DNA combined with ultrasound for diagnosing PP and PA had increased the specificity and the area under ROC curve, and the false positive rate had decreased(P<0.05). The levels of serum CK, AFP, and fetal free DNA combined with ultrasound for diagnosing PP and PA or PI had increased the sensitivity, and had decreased the false negative rate(all P<0.05), but which had not changed the specificity, the false positive rate, and the accuracy(P>0.05). Conclusion: The levels of serum CK, AFP, and fetal free DNA of the pregnant women with PP are high abnormally, which combined with ultrasound for diagnosing PP and PA or PI can increase the diagnostic efficiency.
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