Kofinas A D, Penry M, Swain M, Hatjis C G
Department of Obstetrics and Gynecology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27103.
Am J Obstet Gynecol. 1989 Dec;161(6 Pt 1):1536-9. doi: 10.1016/0002-9378(89)90920-4.
We studied 153 pregnant women with normal pregnancies and 147 women with complicated pregnancies (diabetes, hypertensive disorders, and intrauterine growth retardation) to evaluate the association of placental location and the development of preeclampsia, intrauterine growth retardation, and uterine artery resistance. The placental location was determined by real-time ultrasonography, and the uterine artery resistance was determined by continuous-wave Doppler flow velocity waveform analysis. In the presence of preeclampsia or intrauterine growth retardation, up to 75% of the patients had unilaterally located placentas and 25% central placentas, whereas in the absence of these two conditions only 51% of the patients had unilateral and 49% central placentas (p less than 0.02). In patients with unilateral placentas, the incidence of preeclampsia and intrauterine growth retardation was 2.8-fold and 2.7-fold greater than in patients with central placentas (p less than 0.03 and p less than 0.01). Among all patients unilateral placental location was more likely to be associated with abnormal artery flow velocity waveforms than central placental location (p less than 0.001). We conclude that unilateral placental location may predispose to the development of preeclampsia and intrauterine growth retardation by its effect on uterine artery resistance.
我们研究了153例正常妊娠的孕妇和147例合并妊娠（糖尿病、高血压疾病和胎儿宫内生长受限）的孕妇，以评估胎盘位置与子痫前期、胎儿宫内生长受限及子宫动脉阻力之间的关系。通过实时超声检查确定胎盘位置，通过连续波多普勒流速波形分析确定子宫动脉阻力。子痫前期或胎儿宫内生长受限患者中，高达75%的患者胎盘为单侧，25%为中央型胎盘；而在无这两种情况的患者中，仅51%的患者胎盘为单侧，49%为中央型胎盘（p<0.02）。单侧胎盘患者子痫前期和胎儿宫内生长受限的发生率分别比中央型胎盘患者高2.8倍和2.7倍（p<0.03和p<0.01）。在所有患者中，单侧胎盘位置比中央型胎盘位置更易与异常动脉流速波形相关（p<0.001）。我们得出结论，单侧胎盘位置可能因其对子宫动脉阻力的影响而导致子痫前期和胎儿宫内生长受限的发生。
