Diagnostic value of serum free β chorionic gonadotropin and plasma human placental prolactin mRNA combined with color Doppler ultrasound in the diagnosis of dangerous placenta previa with placental implantation

YANG Haiyang; YUAN Aolong; XIA Lina

doi:10.20258/j.cnki.1006-9011.2025.03.019

Abstract：Objective To explore the clinical value of serum free β-chorionic gonadotropin(β-hCG),plasma human pla-cental prolactin(hPL)mRNA levels and color Doppler ultrasound in the diagnosis of dangerous placenta praevia(PPP)with pla-centa accreta.Methods 96 PPP patients admitted to our hospital were collected as the study subjects,and were grouped into a placental accreta group of 51 cases and a non placental accreta group of 45 cases.Additionally,57 healthy pregnant women were as the control group.Color Doppler ultrasound was applied to diagnose patients;Electrochemiluminescence method was applied to detect serum β-hCG level;Northern blot was applied to detect hPL mRNA level in plasma;receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum β-hCG and plasma hPL levels for PPP combined with placen-tal accreta;and Kappa test was applied to analyze the consistency of serum β-hCG and plasma hPL mRNA levels combined with color Doppler ultrasound in the diagnosis of PPP complicated with placenta accreta.Results Compared with the control group,the level of serum β-hCG and plasma hPL mRNA in the PPP group increased(P<0.05);compared with the non placental ac-creta group,the level of serum β-hCG and plasma hPL mRNA in the placental accreta group increased(P<0.05);and placental implantation in PPP patients was related to cesarean section times and intrauterine infection(P<0.05).Receiver operating char-acteristic analysis showed that the area under the curve(AUC)of serum β-hCG level and plasma hPL mRNA level separately di-agnosed PPP with placental accreta was 0.850 and 0.849;the sensitivity of color ultrasound,serum β-hCG,plasma hPL mRNA levels,and their combined diagnosis was 72.55%,82.35%,and 90.20%,while the specificity was 84.44%,82.22%,and 84.44%;Kappa consistency analysis found that color Doppler ultrasound and serum β-hCG levels independently diagnosed PPP with placental accreta were moderately consistent with the gold standard results(Kappa=0.563、0.565),the serum hPL mRNA level was independently diagnosed and the combined diagnosis of PPP with placental accreta showed high consistency with the gold standard results(Kappa=0.645、0.748).Conclusion Serum β-hCG and plasma hPL mRNA levels are increased in pa-tients with PPP and placenta accreta,and their combination with color Doppler ultrasound has certain clinical diagnosis for PPP and placenta accreta.