Fetal Medicine Unit, Academic Department of Obstetrics and Gynaecology, St George's Hospital Medical School, Blackshaw Road, London, UK.
Placenta. 2010 Dec;31(12):1106-10. doi: 10.1016/j.placenta.2010.10.005. Epub 2010 Oct 29.
Chronic intervillositis of the placenta is known to be associated with poor reproductive outcome and a high risk of recurrence. The aims of the present study were to quantify the risk of recurrence of chronic intervillositis in subsequent pregnancies, to explore if there are possible interventions and to assess the success of interventions.
Systematic review of published literature using published guidelines.
No randomised controlled trials were identified. Sixty-one papers, published between 1977 and 2009 were identified after abstract screening but only 6 studies could be included in the systematic review. From the 6 selected studies, 69 pregnancies at gestational age of 14 weeks or over, with a histopathologic diagnosis of chronic intervillositis were available for analysis. The rate of intrauterine growth restriction in the study population was 66.7%, the overall rate of livebirth was 53.6%. In 16/20 (80.0%) cases recurrence of CI was confirmed at histopathology. The livebirth rate reported with treatment was 30.8% against 58.9% without treatment (RR=0.47, 95% CI=0.2-1.1). This difference was not statistically significant.
Chronic intervillositis has a high (80.0%) recurrence risk. In pregnancies reaching 14 weeks, the chance of a livebirth is 53.6%. The livebirth rate reported with treatment was 30.8% against 58.9% without treatment (RR=0.47, 95% CI=0.2-1.1). This difference was not statistically significant. Intervention with drug therapy is of no demonstrable benefit, and may even be harmful.
已知胎盘慢性绒毛膜炎与不良生殖结局和高复发风险相关。本研究旨在量化后续妊娠中慢性绒毛膜炎复发的风险，探讨是否存在可能的干预措施，并评估干预措施的效果。
使用已发表的指南对已发表文献进行系统综述。
未发现随机对照试验。经过摘要筛选，共确定了 1977 年至 2009 年期间发表的 61 篇论文，但只有 6 项研究可纳入系统综述。在 6 项选定的研究中，有 69 例妊娠在 14 周或以上时，通过组织病理学诊断为慢性绒毛膜炎，可进行分析。研究人群中宫内生长受限的发生率为 66.7%，活产率为 53.6%。在 16/20（80.0%）例中，通过组织病理学证实慢性绒毛膜炎复发。有治疗的活产率为 30.8%，无治疗的活产率为 58.9%（RR=0.47，95%CI=0.2-1.1）。这种差异无统计学意义。
慢性绒毛膜炎有很高的（80.0%）复发风险。在达到 14 周的妊娠中，活产的几率为 53.6%。有治疗的活产率为 30.8%，无治疗的活产率为 58.9%（RR=0.47，95%CI=0.2-1.1）。这种差异无统计学意义。药物治疗干预没有明显的益处，甚至可能有害。
