A study on the diagnostic value of ultrasound combined with serum MK and TSP-1 in diagnosing placental abruption

Objective To explore the clinical value of combined detection of Midkine (MK) and thrombospondin-1 (TSP-1) in serum with ultrasound in the diagnosis of placental abruption. Methods A total of 138 pregnant women with suspected placental abruption during antenatal check-ups at Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University from July 2022 to July 2025 were enrolled. They were divided into a placental abruption group ( n = 88) and a non-placental abruption group ( n = 50) based on whether placental abruption occurred. Both groups underwent ultrasound examination and serum MK and TSP-1 level testing. The serum MK and TSP-1 levels, ultrasound findings, and pregnancy outcomes were compared between the two groups. A combined diagnostic model was constructed using binary logistic regression in R software, and internal validation was performed using bootstrap optimism correction with 500 resamples. The combined diagnostic model performance was evaluated by ROC curve analysis, calibration curves, and decision curve analysis. Results Serum MK and TSP-1 levels were significantly higher in the placental abruption group than in the non-abruption group ( P < 0.05). Ultrasound findings in the placental abruption group were significantly more prevalent than in the non-abruption group ( P < 0.05). The combined diagnostic method showed higher sensitivity, accuracy, and Youden’s index than ultrasound or serum MK/TSP-1 alone, and its AUC was significantly higher than that of each individual marker ( P < 0.05). After bootstrap internal validation, the optimism-corrected AUC was 0.809, and the calibration error (mean absolute error) was 0.09 indicating good model performance. Pregnancy outcomes were significantly poorer in the placental abruption group. Conclusion Ultrasound combined with serum MK and TSP-1 testing may offer potential as an adjunctive diagnostic tool to aid in the evaluation of clinically suspected placental abruption compared to single-marker approaches in this exploratory retrospective cohort.