| Objective To investigate the predictive value of uterine artery parameters combined with thromboelastography(TEG) and coagulation indicators in early missed miscarriage. Methods The clinical data of 364 women in early pregnancy(≤12 weeks of gestation) who were treated at Hefei Maternal and Child Health Hospital from October 2023 to October 2024 were retrospectively analyzed. According to pregnancy outcomes, the patients were divided into a missed abortion group(n=86) and a normal pregnancy group(control group; n=278). Clinical data were collected, including general information, TEG parameters [reaction time(R), coagulation time(K), coagulation angle(Angle), maximum amplitude(MA), coagulation index(CI)], coagulation indicators, and uterine artery parameters [resistance index(RI), pulsatility index(PI)] measured via transvaginal color Doppler ultrasonography. Logistic regression analysis was performed to identify associations between uterine artery parameters combined with TEG and coagulation indicators and early missed miscarriage. ROC curves were used to evaluate the predictive value of these indicators for early missed miscarriage. Results Compared with the normal pregnancy group, MA, CI, D-D, RI, and PI increased in the missed abortion group, while FIB and R decreased, with significant differences between groups(P < 0.05). Univariate and multivariate logistic regression analysis indicated that MA, CI, D-D, RI, and PI were independent risk factors for early missed miscarriage(P<0.05). ROC curve analysis demonstrated that the AUC values of MA, CI, D-D, RI, and PI for predicting early missed miscarriage were 0.748, 0.638, 0.663, 0.580 and 0.597, respectively. The combined use of these indicators provided the highest predictive efficiency, with an AUC of 0.791. Conclusion Uterine artery parameters, thromboelastography, and coagulation indicators may serve as important predictors for early missed miscarriage, and their combined evaluation offers the highest predictive value. |
