Palomba Stefano, Falbo Angela, Chiossi Giuseppe, Tolino Achille, Tucci Luigi, La Sala Giovanni Battista, Zullo Fulvio
Unit of Obstetrics & Gynecology, IRCCS - Arcispedale Santa Maria Nuova, viale Risorgimento 80 - 42123 Reggio Emilia, Italy.
Unit of Obstetrics & Gynecology, IRCCS - Arcispedale Santa Maria Nuova, viale Risorgimento 80 - 42123 Reggio Emilia, Italy.
Reprod Biomed Online. 2014 Sep;29(3):370-81. doi: 10.1016/j.rbmo.2014.04.010. Epub 2014 May 14.
This study evaluated the impact of different phenotypes of polycystic ovary syndrome (PCOS) on early trophoblast invasion and placentation. Pregnant patients with different PCOS phenotypes and healthy pregnant women, matched for age and body mass index, were enrolled. Histological analysis of trophoblastic and decidual tissue and macroscopic and microscopic assessment of the placentas were performed. Implantation-site vessels with endovascular trophoblast differed significantly among PCOS phenotypes. Placental weight, thickness, density and fetal-placental weight ratio were significantly different in the full-blown and non-polycystic ovary (PCO) phenotypes versus the ovulatory and non-hyperandrogenic phenotypes. The incidence of macroscopic placental lesions was only significantly different between controls and the full-blown and non-PCO phenotypes. The overall incidence of microscopic placental lesions was significantly different among PCOS phenotypes and was significantly higher in the full-blown and non-PCO phenotypes than in the ovulatory and non-hyperandrogenic phenotypes. The rates of chorionic villitis and intervillositis were significantly higher in full-blown and non-PCO phenotypes than in ovulatory and non-hyperandrogenic phenotypes. In conclusion, alterations in early trophoblast invasion and placentation observed in PCOS vary widely according to phenotype.
本研究评估了多囊卵巢综合征（PCOS）的不同表型对早期滋养层细胞侵袭和胎盘形成的影响。纳入了年龄和体重指数相匹配的不同PCOS表型的孕妇及健康孕妇。对滋养层和蜕膜组织进行了组织学分析，并对胎盘进行了宏观和微观评估。不同PCOS表型中，具有血管内滋养层细胞的着床部位血管存在显著差异。与排卵型和非高雄激素表型相比，典型PCOS和非多囊卵巢（PCO）表型的胎盘重量、厚度、密度及胎儿-胎盘重量比存在显著差异。宏观胎盘病变的发生率仅在对照组与典型PCOS和非PCO表型之间存在显著差异。微观胎盘病变的总体发生率在PCOS各表型之间存在显著差异，且典型PCOS和非PCO表型显著高于排卵型和非高雄激素表型。典型PCOS和非PCO表型的绒毛膜羊膜炎和绒毛间炎发生率显著高于排卵型和非高雄激素表型。总之，PCOS中观察到的早期滋养层细胞侵袭和胎盘形成的改变因表型而异。
