Carles Dominique, Pelluard Fanny, Alberti Eve Marie, Gangbo Flore
Unite de Pathologie Foetoplacentaire, Service d'Anatomie Pathologique, Groupe Hospitalier Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux.
Bull Acad Natl Med. 2005 Nov;189(8):1789-99; discussion 1799-801.
The objective of this works to determine the frequency and nature of malformations detected by pathological study of aborted and stillborn third-trimester fetuses. The data were extracted from the files of the fetoplacental unit of Bordeaux University Hospital between January 2000 and December 2003. The study focused on fetuses with a gestational age corresponding to the third trimester (27 weeks to term). Death resulted from either induced abortion (IA) or spontaneous intrauterine death (IUD). A total of 1963 fetopathological examinations were performed during the study period, of which 524 involved third-trimester fetuses (109 IA, 49 IUD). The 109 IA represented nearly 15% of all abortions performed for medical reasons during the study period. The mean gestational age was 31.2 weeks in the IA group and 34.3 weeks in the IUD group (p < 1 per thousand). The abnormalities most frequently observed in the IA group consisted of neurological disorders (34 cases), cardiovascular disorders (26 cases), genetic syndromes (20 cases) and chromosomal aberrations (18 cases). In the IUDm group there were 20 minor malformations and 29 major malformations. The latter included 7 cardiac malformations, 7 central nervous system disorders, and 5 syndromes (Di George, n=3 ; Down's, n=2). The disorders indicating IA vere detected during the third trimester in 94 cases, and earlier in the other 15 cases. Despite the retrospective nature of this study, the results show that a significant number of major congenital malformations are only detected in the third trimester, by sonographic examination. This is compatible with the high frequency of major congenital malformations discovered at post mortem examination of third-trimester stillbirths.
这项工作的目的是确定通过对妊娠晚期流产和死产胎儿进行病理学研究检测到的畸形的频率和性质。数据取自2000年1月至2003年12月间波尔多大学医院胎儿-胎盘单位的档案。该研究聚焦于妊娠晚期（27周足月）的胎儿。死亡原因要么是人工流产（IA），要么是自然宫内死亡（IUD）。在研究期间共进行了1963次胎儿病理学检查，其中524例涉及妊娠晚期胎儿（109例人工流产，49例自然宫内死亡）。109例人工流产占研究期间所有因医学原因进行的流产的近15%。人工流产组的平均孕周为31.2周，自然宫内死亡组为34.3周（p<1‰）。人工流产组最常观察到的异常包括神经系统疾病（34例）、心血管疾病（26例）、遗传综合征（20例）和染色体畸变（18例）。在自然宫内死亡组中有20例轻微畸形和29例严重畸形。后者包括7例心脏畸形、7例中枢神经系统疾病和5种综合征（迪格奥尔格综合征，n=3；唐氏综合征，n=2）。表明人工流产的疾病在妊娠晚期检测到94例，在其他15例中检测得更早。尽管本研究具有回顾性，但结果表明，通过超声检查，大量主要先天性畸形仅在妊娠晚期才被检测到。这与妊娠晚期死产尸检时发现的主要先天性畸形的高频率相符。
