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[足月时的胎盘成熟度与胎盘功能表现:与胎盘成熟储备组织学检测相关的CTG变化]

[Placental maturity at term and functional placental performance: CTG changes in relation to histologic detection of placental maturation reserves].

作者信息

Beck T, Weber G, Weikel W

机构信息

Universitäts-Frauenklinik Mainz.

出版信息

Geburtshilfe Frauenheilkd. 1991 Sep;51(9):714-21. doi: 10.1055/s-2007-1023821.

DOI:10.1055/s-2007-1023821
PMID:1743471
Abstract

Cardiotocography (CTG) is to be considered today's most sensitive monitoring tool for the functional surveillance of placental performance during parturition. 351 cardiotocographically monitored singleton pregnancies were used as patient material for fine tissue examination of the state of maturity of the villi of the relevant placentas. In histological assessment, placental diagnoses are allocated to defined CTG changes; in particular, however, the identification of reserves, capable of maturing (immature intermediate villi in the centres of the placental subdivisions or placentones), is subject to separate scrutiny. The following results emerge clearly: terminal placentas without maturing potentials, prematurely matured placentas and placentas with deficiency of terminal villi, as well as the absence of immature intermediate villi in the centers of the placentones, are connected with a suspected prepathological or pathological CTG assessment. The histological groups have the lowest incidence of the normal oscillatory type and normal oscillatory frequency and have the highest proportion of abnormal CTG assessments according to the Hammacher score. The absence of the identification of potential maturing reserves (immature intermediate villi) is associated with the highest incidence of Caesarean sections (29.8%). These results show, that the physiological maturing potentials (immature intermediate villi) which can be identified up to term are a histological indication towards regular placental performance, even in labour.

摘要

如今,产时胎儿心率电子监护(CTG)被认为是监测胎盘功能最敏感的工具。选取351例接受CTG监测的单胎妊娠作为研究对象,对其胎盘绒毛成熟度进行精细组织学检查。在组织学评估中,将胎盘诊断结果与特定的CTG变化相对应;然而,对于能够成熟的储备(胎盘小叶或胎盘单位中心的未成熟中间绒毛)的识别,需单独进行审查。以下结果清晰可见:无成熟潜能的终末胎盘、过早成熟的胎盘、终末绒毛缺乏的胎盘,以及胎盘单位中心无未成熟中间绒毛,均与可疑的病理前或病理CTG评估相关。根据哈马赫尔评分,这些组织学组的正常摆动型和正常摆动频率发生率最低,异常CTG评估比例最高。未识别出潜在成熟储备(未成熟中间绒毛)的情况与剖宫产最高发生率(29.8%)相关。这些结果表明,直至足月仍可识别的生理成熟潜能(未成熟中间绒毛)是胎盘功能正常的组织学指标,即使在分娩时也是如此。

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