Biswas Sharmistha, Ghosh Samit K, Chhabra Shakuntala
Mahatma Gandhi Institute of Medical Sciences, Sevagram, District Wardha (MS), India.
J Obstet Gynaecol Res. 2008 Aug;34(4):487-93. doi: 10.1111/j.1447-0756.2008.00719.x.
Histomorphometric studies of placentas from idiopathic intrauterine growth restricted (IUGR) fetuses as well as normal-weight (control) fetuses were performed to determine surface area of chorionic villi (mostly terminal and few intermediate) using stereological technique. The results were compared to determine the difference in the values of surface area of chorionic villi, and to establish any relationship between placental histomorphometric changes and IUGR.
Placentas from fifty (50) full-term, uncomplicated deliveries were collected; twenty eight (28) of them were associated with IUGR babies and twenty two (22) were from normal-weight babies. Placental weights and volumes were measured. Pieces of placental tissues were formalin-fixed, processed and embedded in paraffin. Seven-micron sections were cut and stained with HE stain. Histomorphometric and stereological studies were performed.
IUGR placental weights and volumes were lower than those of controls. Surface areas of villi of IUGR placentas had a mean of 8.19 m(2) (SD +/- 2.88). For control placentas, the mean was 10.02 m(2) (SD +/- 1.83). The mean value of the surface area of villi of the IUGR group was significantly lower than that of the control group.
These findings pointed to a defect in the normal interaction between trophoblast and maternal tissue, leading to a reduced surface area of villi. Because the surface area of the villi presents the interface between maternal and fetal circulation, its reduction might be the cause of idiopathic intrauterine growth restriction.
对特发性宫内生长受限(IUGR)胎儿以及正常体重(对照)胎儿的胎盘进行组织形态计量学研究,采用体视学技术确定绒毛膜绒毛(主要是终末绒毛和少量中间绒毛)的表面积。比较结果以确定绒毛膜绒毛表面积值的差异,并建立胎盘组织形态计量学变化与IUGR之间的任何关系。
收集50例足月、无并发症分娩的胎盘;其中28例与IUGR婴儿相关,22例来自正常体重婴儿。测量胎盘重量和体积。将胎盘组织块用福尔马林固定、处理并石蜡包埋。切成7微米切片,用苏木精-伊红染色。进行组织形态计量学和体视学研究。
IUGR胎盘重量和体积低于对照组。IUGR胎盘绒毛的表面积平均为8.19平方米(标准差±2.88)。对照胎盘的平均值为10.02平方米(标准差±1.83)。IUGR组绒毛表面积的平均值显著低于对照组。
这些发现表明滋养层与母体组织之间正常相互作用存在缺陷,导致绒毛表面积减少。由于绒毛表面积是母体和胎儿循环的界面,其减少可能是特发性宫内生长受限的原因。