Nigam Js, Misra V, Singh P, Singh Pa, Chauhan S, Thakur B
Department of Pathology, Saraswathi Institute of Medical Sciences, Anwarpur, Pilkhuwa, Hapur, Uttar Pradesh, India.
Department of Pathology, M.L.N. Medical College, Allahabad, Uttar Pradesh, India.
Ann Med Health Sci Res. 2014 Jul;4(Suppl 2):S79-83. doi: 10.4103/2141-9248.138016.
The antenatal health-care given to pregnant women has great influence on the rates of perinatal death and morbidity. Amongst the different causes of perinatal mortality, low birth weight (LBW) is the single most significant factor therefore placenta from all the LBW babies (LBWB) should be examined routinely to find out the likely cause.
The aims of this study were to assess the pathological changes in the placenta in association with LBWB.
This is a Case control study performed at Medical College Allahabad,(MLN) India. In this study, 90 placentae were included. 30 placentae from full-term vaginally delivered babies, weighing more than 2500 g were included as the control group. 60 placentae belonged to babies whose birth weight was less than 2500 g (LBW). Weight of the baby was taken within the 1(st) h of birth and Apgar score was noted. Gross and microscopic examination of placentae was done. Statistical correlation of was carried out between them by using SPSS 18 version. Chi-square test with or without yate's correction was used as and when required. P < 0.05 was taken as critical level of significance.
Placenta was circum-marginal in both groups. Attachment of cord was mainly central in the control group 90% (27/30), whereas eccentric attachment was prominent in patient group 66.67% (40/60). The difference was statistically significant (P < 0.001). Calcification and sub-chorionic fibrin deposition was seen in significantly higher numbers of placentae from patients than controls (P < 0.01) infarction and meconium staining were seen in placentae from patients only. Histologically placental ischemia, infarction and calcification were seen in significantly higher number of patients (P < 0.001, P < 0.001 and < 0.01 respectively). Fibrinoid necrosis, stromal fibrosis, placental dysmaturity and obstructive vasculopathy were seen in placentae from patients only.
Placental pathology among LBW infants was high in comparison to control group. The findings suggest that chronic ischemia and associated secondary changes probably lead to improper perfusion and LBWB.
给予孕妇的产前保健对围产期死亡率和发病率有很大影响。在围产期死亡的不同原因中，低出生体重（LBW）是最显著的单一因素，因此所有低出生体重儿（LBWB）的胎盘都应进行常规检查以找出可能的原因。
本研究的目的是评估与低出生体重儿相关的胎盘病理变化。
这是一项在印度阿拉哈巴德医学院（MLN）进行的病例对照研究。本研究纳入了90个胎盘。30个来自足月阴道分娩、体重超过2500g的婴儿的胎盘被纳入对照组。60个胎盘属于出生体重小于2500g（LBW）的婴儿。在出生后第1小时内测量婴儿体重并记录阿氏评分。对胎盘进行大体和显微镜检查。使用SPSS 18版本对它们进行统计相关性分析。根据需要使用有或无耶茨校正的卡方检验。P<0.05被视为临界显著性水平。
两组胎盘均为边缘性。对照组中脐带附着主要为中央型，占90%（27/30），而患者组中偏心附着较为突出，占66.67%（40/60）。差异具有统计学意义（P<0.001）。患者胎盘的钙化和绒毛膜下纤维蛋白沉积明显多于对照组（P<0.01），梗死和胎粪染色仅见于患者胎盘。组织学上，患者胎盘的缺血、梗死和钙化明显更多（分别为P<0.001、P<0.001和P<0.01）。纤维蛋白样坏死、间质纤维化、胎盘发育不全和阻塞性血管病仅见于患者胎盘。
与对照组相比，低出生体重儿的胎盘病理学情况较多。研究结果表明，慢性缺血及相关的继发性变化可能导致灌注不良和低出生体重儿。
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