Günyeli Ilker, Erdemoğlu Evrim, Ceylaner Serdar, Zergeroğlu Sema, Mungan Tamer
Department of Obstetric and Gynecology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey.
Department of Genetics, Zekai Tahir Burak Women Health Education and Research Hospital, Ankara, Turkey.
J Turk Ger Gynecol Assoc. 2011 Jun 1;12(2):75-9. doi: 10.5152/jtgga.2011.19. eCollection 2011.
Placental factors and hypoxemia are the keys to intrauterine growth restriction (IUGR) and stillbirth. The aim of the study is to analyze histological changes in placentas of IUGR fetuses in pregnancies with no apparent etiologic factor and unexplained intrauterine fetal deaths.
A total of 110 placentas were collected; 26 placentas of IUGR fetuses with no apparent cause, 58 placentas from unexplained intrauterine deaths over 20 weeks of gestation, and 26 placentas from uncomplicated pregnancies who delivered a healthy live baby. Microscopic examinations of placentas were performed for histopathological analyzes.
Gestational age at delivery was 33.67±4.37 weeks, 29.15±8.36 weeks, and 39.0±1.52 weeks in women in group I, group II and group III, respectively (p<0.01). Infarction and intervillous thrombosis are significantly more frequent in placentas of Group I and group II. Chronic villitis occurred in 69%, 63% and 30% of group I, group II, and group III, respectively. Placental intravascular thrombi (Group I, 31% and group II, 26%), perivillous fibrin deposition and fibrinoid necrosis (65% in Group I and 53% in group II), infarction, intervillous thrombosis, chronic villitis, hemorrhagic endovasculitis, placental intravascular thrombi, perivillous fibrin deposition, fibrinoid necrosis, erythroblastosis and villous edema were found in the study group.
The results reported here indicate that a relationship exists between morphological changes in the placentas of IUGR and intrauterine fetal deaths.
胎盘因素和低氧血症是宫内生长受限(IUGR)和死产的关键因素。本研究旨在分析无明显病因的IUGR胎儿胎盘以及不明原因的宫内胎儿死亡病例胎盘的组织学变化。
共收集110份胎盘;26份无明显病因的IUGR胎儿胎盘,58份孕20周以上不明原因宫内死亡病例的胎盘,以及26份分娩健康活婴的正常妊娠胎盘。对胎盘进行显微镜检查以进行组织病理学分析。
I组、II组和III组产妇的分娩孕周分别为33.67±4.37周、29.15±8.36周和39.0±1.52周(p<0.01)。I组和II组胎盘梗死和绒毛间血栓形成明显更常见。慢性绒毛炎分别发生在I组的69%、II组的63%和III组的30%。研究组发现有胎盘血管内血栓形成(I组31%,II组26%)、绒毛周围纤维蛋白沉积和纤维蛋白样坏死(I组65%,II组53%)、梗死、绒毛间血栓形成、慢性绒毛炎、出血性血管内炎、胎盘血管内血栓形成、绒毛周围纤维蛋白沉积、纤维蛋白样坏死、成红细胞增多症和绒毛水肿。
本研究结果表明,IUGR胎盘形态学变化与宫内胎儿死亡之间存在关联。