Ruchelli E D, Shen-Schwarz S, Martin J, Surti U
Department of Pathology, Magee-Women's Hospital, Pittsburgh, Pennsylvania.
Pediatr Pathol. 1990;10(5):743-56. doi: 10.3109/15513819009064709.
We compared the pathologic and ultrasonographic findings of 31 first trimester spontaneous abortions to determine the benefits of such studies. The ultrasound diagnoses included empty gestational sac (n = 11), intrauterine fetal death (n = 11), abortion in progress or incomplete abortion (n = 8), and live embryo (n = 1). Two subgroups of empty sacs were identified by pathologic examination. Embryonic development appeared to be more advanced in one group as indicated by the presence of embryonic red blood cells (RBC's) in the placental vessels. Although an embryo or fetus was identified more frequently by sonar than by pathologic examination, we were able to diagnose developmental anomalies in small embryos that current ultrasound equipment cannot resolve. Such anomalies were identified even in the presence of fetal heart activity. Pathologic examination was also informative when heavy bleeding obscured the contents of the uterine cavity to sonar and was thus supplementary of a suboptimal ultrasound examination. Placental examination proved to be reliable in assessing gestational age at the time of embryonic/fetal death. There was a good correlation between RBC morphology and sonographic measurement of crown-rump length. First trimester ultrasound and pathologic examination of the embryo and placenta are informative and complement each other.
我们比较了31例孕早期自然流产的病理和超声检查结果，以确定此类研究的益处。超声诊断包括空妊娠囊（n = 11）、宫内胎儿死亡（n = 11）、流产进行中或不全流产（n = 8）以及活胚胎（n = 1）。通过病理检查确定了空囊的两个亚组。一组胎盘血管中存在胚胎红细胞（RBC），表明胚胎发育似乎更成熟。尽管超声比病理检查更频繁地识别出胚胎或胎儿，但我们能够诊断出现有超声设备无法分辨的小胚胎发育异常。即使在有胎心活动的情况下也能识别出此类异常。当大量出血使超声无法看清宫腔内容物时，病理检查也能提供信息，因此可作为不理想超声检查的补充。胎盘检查在评估胚胎/胎儿死亡时的孕周方面被证明是可靠的。红细胞形态与头臀长度的超声测量之间存在良好的相关性。孕早期超声以及胚胎和胎盘的病理检查都能提供信息且相互补充。
