Biswas Sharmistha, Ghosh S K
Department of Anatomy, Calcutta National Medical College, 32, Gorachand Road, Kolkata 700014, India.
Early Hum Dev. 2008 Jun;84(6):357-62. doi: 10.1016/j.earlhumdev.2007.09.017. Epub 2008 Feb 21.
The present study aimed to throw light to any gross morphological changes of placenta that might contribute to the development of idiopathic IUGR. Gross examination of placentas from full-term uncomplicated pregnancies delivering singleton live IUGR babies, and live normal-weight babies (controls) were performed; then the results were compared. Fifty full-term freshly delivered placentas were collected both from normal deliveries and C.S. Twenty-eight (28) placentas were associated with IUGR and twenty-two (22) were from controls. The positions of insertion of the umbilical cords, placental weights, volumes and diameters were noted. These gross examinations revealed that the control placentas were bigger in diameters, had usual positions of insertion of umbilical cords, mean placental weight was 416.77 gm and mean placental volume was 343.86 ml. In cases of IUGR placentas, there were some abnormal positions of insertion of umbilical cords in 11% placentas (marginal in 7.14% and velamentous in 3.57%), and placental weight and volume was significantly lower (p value<0.001). The placentas associated with IUGR were smaller in diameters than those of control group of placentas. The mean placental co-efficient of IUGR group in the present study was 0.156 (range 0.11-0.22) and that of the control group was 0.138 (range 0.12-0.18). The greater placental co-efficient in IUGR indicates that although both placentas and babies in IUGR had less weight, placental sizes were not relatively less. In fact, these placentas were functional, and even tried to compensate the abnormal morphology. Therefore, though IUGR fetuses were more frequently associated with morphologically abnormal placentas, it could not be conclusively decided whether this abnormal gross morphology actually contributed to the intrauterine growth restriction.
本研究旨在揭示胎盘可能导致特发性胎儿生长受限（IUGR）的任何大体形态学变化。对足月分娩单胎活产IUGR婴儿和活产正常体重婴儿（对照组）的胎盘进行了大体检查；然后对结果进行比较。从正常分娩和剖宫产中收集了50个足月新鲜胎盘。28个胎盘与IUGR相关，22个来自对照组。记录了脐带插入位置、胎盘重量、体积和直径。这些大体检查显示，对照胎盘直径更大，脐带插入位置正常，平均胎盘重量为416.77克，平均胎盘体积为343.86毫升。在IUGR胎盘病例中，11%的胎盘脐带插入位置异常（边缘性插入占7.14%，帆状插入占3.57%），胎盘重量和体积显著降低（p值<0.001）。与IUGR相关的胎盘直径小于对照组胎盘。本研究中IUGR组的平均胎盘系数为0.156（范围0.11 - 0.22），对照组为0.138（范围0.12 - 0.18）。IUGR中较大的胎盘系数表明，尽管IUGR中的胎盘和婴儿体重都较轻，但胎盘大小相对并不小。事实上，这些胎盘是有功能的，甚至试图补偿异常形态。因此，尽管IUGR胎儿更常与形态异常的胎盘相关，但不能确凿地确定这种异常的大体形态是否实际上导致了宫内生长受限。
