Emmrich P
Institut für Pathologische Anatomie, Bereiches Medizin der Universität Leipzig.
Zentralbl Pathol. 1991;137(5):385-94.
A general account of routes of infection is followed by reference to localisations of placental infection. The most common routes of infection are transmembrane, transdecidual, haematogenico-maternal, and haematogenico-foetal. Intra-uterine infections with placental involvement may be caused by several types of pathogens, with particular reference being made to listeriosis, tuberculosis, and lues, while virus infections may be associated with rubella and cytomegaly and protozoonosis with toxoplasmosis. Unambiguous morphological traces are left in the placenta merely by few of these "specific" infections. A possible pathogen, therefore, can be rarely concluded from the type of inflammatory placental involvement. Reference is also made to "villitis of unknown aetiology", an aetiologically obscure, probably haematogenico-maternal infection of the placenta. Introduction of this term to histological routine diagnosis is recommended. This account of placental inflammation is completed by explanations on relationships between inflammation and impaired maturation of the placenta as well as between inflammation and intervillous fibrin deposition or chronic disorders of intervillous circulation.
在介绍胎盘感染的定位之前,先对感染途径进行概述。最常见的感染途径是跨膜、经蜕膜、血源性母体和血源性胎儿途径。累及胎盘的宫内感染可能由几种病原体引起,特别提到了李斯特菌病、结核病和梅毒,而病毒感染可能与风疹和巨细胞病毒有关,原生动物病则与弓形虫病有关。这些“特异性”感染中只有少数会在胎盘中留下明确的形态学痕迹。因此,很少能从胎盘炎症的类型推断出可能的病原体。文中还提到了“病因不明的绒毛炎”,这是一种病因不明、可能为血源性母体感染的胎盘疾病。建议将该术语引入组织学常规诊断。通过解释炎症与胎盘成熟受损之间的关系以及炎症与绒毛间隙纤维蛋白沉积或绒毛间隙循环慢性紊乱之间的关系,完成了对胎盘炎症的阐述。