Emmrich P
Institut für Pathologische Anatomie, Bereiches Medizin der Universität Leipzig, Deutschland.
Zentralbl Pathol. 1991;137(6):479-85.
Asphyxial infiltrates of the afterbirth (umbilical cord and placenta) are believed to be non-inflammatory round-cell to leucocytic infiltrates on the following sites: wall of greater vessels of umbilical cord, chorionic membrane, and, less often, stem villi as well as in the chorionic membrane proper. There has also been cellular to primarily leucocytic subchorial demarcation, usually between chorionic plate and Langhans fibrin or even in Langhans fibrin. Also recorded were parietal thrombi in greater arteries of chorionic membrane and stem villi, usually in concomitance round-cell infiltration of the arterial wall in the sense of asphyxial infiltrates. Those alterations are considered to be an entity associated to intra-uterine foetal asphyxia, with extended duration of parturition being though to play a particular role as a trigger factor of asphyxia. The author's own investigations of such alterations to afterbirths from high-risk pregnancies as well as to a consecutive series of newborns without increased risk have shown for either group that no statistical relationship existed between high-risk factors of asphyxia prior to or during labour, on the one hand, and such asphyxial infiltrates, on the other, not even in cases of prolonged labour. While we are not in a position at present to clearly define this complex in terms of genetic causality, we should like to maintain it under the heading of "asphyxial infiltrates" for the purpose of placental diagnosis.
产后（脐带和胎盘）的窒息性浸润被认为是以下部位的非炎症性圆形细胞到白细胞浸润：脐带大血管壁、绒毛膜，较少见的是干绒毛以及绒毛膜本身。在绒毛膜下也存在细胞到主要为白细胞的分界，通常在绒毛板和朗汉斯纤维蛋白之间，甚至在朗汉斯纤维蛋白内。还记录到绒毛膜和干绒毛较大动脉中的壁血栓，通常伴有动脉壁的圆形细胞浸润，属于窒息性浸润。这些改变被认为是与宫内胎儿窒息相关的一种情况，分娩时间延长被认为是窒息的一个特别触发因素。作者自己对高危妊娠产后以及一系列无增加风险的连续新生儿的此类改变进行的研究表明，对于两组而言，一方面分娩前或分娩期间窒息的高危因素与另一方面的此类窒息性浸润之间均无统计学关系，即使在分娩延长的情况下也是如此。虽然目前我们无法从遗传因果关系方面明确界定这一复杂情况，但为了胎盘诊断的目的，我们愿意将其归入“窒息性浸润”这一类别。
