Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2024; 12(17): 3053-3060
Published online Jun 16, 2024. doi: 10.12998/wjcc.v12.i17.3053
Diagnostic efficacy of virtual organ computer-assisted analysis in measuring the volume ratio of subchorionic hematoma with serum progesterone
Lin-Ling Shen, Jing Shi, Chang-Wei Ding, Gao-Le Dai, Qi Ma
Lin-Ling Shen, Chang-Wei Ding, Gao-Le Dai, Qi Ma, Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu Province, China
Jing Shi, Department of Ultrasound, Wuxi People’s Hospital of Nanjing Medical University, Wuxi 211103, Jiangsu Province, China
Co-first authors: Lin-Ling Shen and Jing Shi.
Author contributions: Shen LL and Wang Ma Q conceptualized this study, Shi J, and Ding CW contributed to data collection; Shen LL and Dai GL drafted the initial manuscript and contributed to formal analysis; Ma Q provided guidance for this study and contributed to methodology and visualization together with Ding CW; Shen LL and Ma Q validated this study; Shen LL and Shi J, as the first authors, have made equal contributions to this study; All authors participated in this study and jointly reviewed and edited the manuscript.
Institutional review board statement: This study has received ethical review and approval from the Second Affiliated Hospital of Soochow Universe.
Informed consent statement: This study has obtained the consent of the patient or guardian.
Conflict-of-interest statement: We declare that there is no conflict of interest disclosure.
Data sharing statement: No available data.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/.
Corresponding author: Qi Ma, MD, Chief Physician, Department of Ultrasound, The Second Affiliated Hospital of Soochow University, No. 1055 Sanxiang Road, Gusu District, Suzhou 215004, Jiangsu Province, China. maqisz@163.com
Received: March 4, 2024
Revised: April 15, 2024
Accepted: April 22, 2024
Published online: June 16, 2024
Processing time: 92 Days and 7.9 Hours
Abstract
BACKGROUND

Subchorionic hematoma (SCH) is a common complication in early pregnancy characterized by the accumulation of blood between the uterine wall and the chorionic membrane. SCH can lead to adverse pregnancy outcomes such as miscarriage, preterm birth, and other complications. Early detection and accurate assessment of SCH are crucial for appropriate management and improved pregnancy outcomes.

AIM

To evaluate the diagnostic efficacy of virtual organ computer-assisted analysis (VOCAL) in measuring the volume ratio of SCH to gestational sac (GS) combined with serum progesterone on early pregnancy outcomes in patients with SCH.

METHODS

A total of 153 patients with SCH in their first-trimester pregnancies between 6 and 11 wk were enrolled. All patients were followed up until a gestational age of 20 wk. The parameters of transvaginal two-dimensional ultrasound, including the circumference of SCH (Cs), surface area of SCH (Ss), circumference of GS (Cg), and surface area of GS (Sg), and the parameters of VOCAL with transvaginal three-dimensional ultrasound, including the three-dimensional volume of SCH (3DVs) and GS (3DVg), were recorded. The size of the SCH and its ratio to the GS size (Cs/Cg, Ss/Sg, 3DVs/3DVg) were recorded and compared.

RESULTS

Compared with those in the normal pregnancy group, the adverse pregnancy group had higher Cs/Cg, Ss/Sg, and 3DVs/3DVg ratios (P < 0.05). When 3DVs/3DVg was 0.220, the highest predictive performance predicted adverse pregnancy outcomes, resulting in an AUC of 0.767, and the sensitivity, specificity were 70.2%, 75% respectively. VOCAL measuring 3DVs/3DVg combined with serum progesterone gave a diagnostic AUC of 0.824 for early pregnancy outcome in SCH patients, with a high sensitivity of 82.1% and a specificity of 72.1%, which showed a significant difference between AUC.

CONCLUSION

VOCAL-measured 3DVs/3DVg effectively quantifies the severity of SCH, while combined serum progesterone better predicts adverse pregnancy outcomes.

Keywords: Subchorionic hematoma; Virtual organ computer-assisted analysis; Gestational sac; Serum progesterone; Ultrasound parameters; Adverse pregnancy outcomes

Core Tip: This study demonstrates the utility of virtual organ computer-assisted analysis (VOCAL) in assessing subchorionic hematoma (SCH) severity by measuring the 3D volume ratio of SCH to gestational sac (GS) in early pregnancy. The combination of VOCAL measurements with serum progesterone levels significantly improves the prediction of adverse pregnancy outcomes. Higher ratios of SCH to GS size were associated with adverse outcomes, with VOCAL-measured 3DVs/3DVg showing the highest predictive performance. These findings highlight the importance of advanced imaging techniques and biomarkers for early SCH assessment and management in pregnant patients.