Robinson Barrett K, Su Emily, Grobman William, Huang Michael, Ernst Linda M
Department of Obstetrics/Gynecology, Indiana University School of Medicine, Indianapolis, IN, USA.
Pediatr Dev Pathol. 2012 Jul-Aug;15(4):298-302. doi: 10.2350/12-02-1158-OA.1. Epub 2012 Jun 6.
The present study assessed whether placentas in women delivered by cesarean for category II fetal heart tracings (FHT) exhibit a higher incidence of acute inflammation than those of women delivered by cesarean for labor arrest. This case control study included singleton pregnancies ≥36 weeks of gestation delivered by cesarean for an FHT indication (cases) or because of labor arrest (controls) 2005-2009 at Prentice Women's Hospital. Exclusions were maternal diabetes, hypertension, known thrombophilia, connective tissue disorders, clinical evidence of chorioamnionitis, placental abruption, fetal anomalies, stillbirth, or an infant with a birth weight less than the 10th percentile. Women were included in the case group if the indication for cesarean delivery was based on the FHT and review of the FHT determined that they were designated as category II prior to delivery. A perinatal pathologist, unaware of indications for delivery, assessed placental inflammation in maternal and fetal compartments. Stage and grade of acute inflammation, from none to severe (scored 0-3), in the membranes, chorionic plate, chorionic vessels, and umbilical cord were assessed, and overall maternal and fetal inflammatory stages were assigned. Findings indicative of chronic inflammation were also noted. Other than lower umbilical artery cord gases in women with category II FHT, cases (n = 51) and controls (n = 27) had similar baseline characteristics and newborn outcomes, as well as similar placental pathologic findings. In uncomplicated patients, the presence or extent of placental inflammation does not appear to differ between women delivered for category II FHT and labor arrest.
本研究评估了因II类胎儿心率监测（FHT）而行剖宫产的女性的胎盘，与因产程停滞而行剖宫产的女性的胎盘相比，急性炎症发生率是否更高。这项病例对照研究纳入了2005年至2009年在普伦蒂斯妇女医院因FHT指征（病例组）或产程停滞（对照组）而行剖宫产的单胎妊娠≥36周的孕妇。排除标准包括母体糖尿病、高血压、已知的血栓形成倾向、结缔组织疾病、绒毛膜羊膜炎的临床证据、胎盘早剥、胎儿畸形、死产或出生体重低于第10百分位数的婴儿。如果剖宫产指征基于FHT，且对FHT的复查确定其在分娩前被指定为II类，则该女性被纳入病例组。一名对分娩指征不知情的围产期病理学家评估了母胎胎盘的炎症情况。评估了胎膜、绒毛膜板、绒毛膜血管和脐带中急性炎症的分期和分级，从无到严重（评分为0 - 3），并确定了总体母胎炎症分期。还记录了慢性炎症的表现。除了II类FHT女性的脐动脉血气体值较低外，病例组（n = 51）和对照组（n = 27）的基线特征、新生儿结局以及胎盘病理表现相似。在无并发症的患者中，因II类FHT和产程停滞而行剖宫产的女性之间，胎盘炎症的存在或程度似乎没有差异。
