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| Effect of the conservative treatment of the tubal pregnancy of patients evaluated by transvaginal ultrasound combined with the levels of serum vascular endothelial growth factor, estrogen and progesterone |
| Yuncheng Central Hospital Affiliated to Shanxi Medical University, Yuncheng, Shanxi Province, 044000 |
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Abstract To evaluate the effect of the conservative treatment of the tubal pregnancy of patients evaluated by transvaginal ultrasound combined with the levels of serum vascular endothelial growth factor (VEGF), estrogen and progesterone. Methods: 117 patients with tubal pregnancy admitted to the hospital from March 2019 to March 2023 were selected retrospectively. All the patients were given conservative treatment after transvaginal ultrasound examination. These patients were divided into group A (43 cases with the conversion to the surgery after the failure of conservative treatment) and group B (74 cases with successful conservative treatment) according to the outcomes of the conservative treatment. The basic data, the transvaginal ultrasound parameters values before treatment, the levels of serum VEGF, estrogen and progesterone of the patients were compared between the two groups. The risk factors affecting the conversion to the surgery of the patients after the failure of conservative treatment were analyzed. Receiver operating characteristic (ROC) curve was used to analyze the value of the transvaginal ultrasound examination combined with the serum VEGF, estrogen and progesterone levels of the patients for evaluating their conversion to the surgery after the failure of conservative treatment. Results: The mass volume of the adnexa uteri, the levels of serum β-human chorionic gonadotropin(β-hCG), VEGF, E2 and P of the patients in group A were significantly higher than those of the patients in group B, and the resistance index (RI) of ultrasound of the patients was significantly lower than that of the patients in group B (P<0.05). Logistic regression analysis showed that the mass volume of the adnexa uteri, the elevated serum levels of β-hCG, VEGF, E2, and P, and the decreased RI value of the patients were the independent risk factors of their conversion to the surgery after the failure of conservative treatment of the tubal pregnancy (P<0.05). ROC curve analysis showed that the area under the curve of the mass volume of the adnexa uteri, the RI value, the serum VEGF level, the E2 level, the P level, and the combination of the mass volume of the adnexa uteri, the RI value, the serum VEGF level, the E2 level and the P level of the patients for predicting their failure of conservative treatment were 0.850, 0.807, 0.758, 0.707, 0.736 and 0.916, respectively. The sensitivity and the specificity of the combination of the mass volume of the adnexa uteri, the RI value, the serum VEGF level, the E2 level and the P level of the patients for predicting their failure of conservative treatment were 90.7% and 85.1%. Conclusion: The combination of the transvaginal ultrasound examination, and the levels of the serum VEGF, E2 and P of the patients for predicting their conversion to the surgery after the failure of conservative treatment of the tubal pregnancy has higher clinical value.
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