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胎粪吸入综合征中的胎盘病变

Placental Lesions in Meconium Aspiration Syndrome.

作者信息

Kim Binnari, Oh Soo-Young, Kim Jung-Sun

机构信息

Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

J Pathol Transl Med. 2017 Sep;51(5):488-498. doi: 10.4132/jptm.2017.07.20. Epub 2017 Aug 9.

Abstract

BACKGROUND

Meconium aspiration syndrome (MAS) is defined by respiratory distress requiring supplemental oxygen in a meconium-stained neonate. MAS is clinically subclassified as mild, moderate, and severe according to the oxygen requirement. The aims of this study were to compare the histological findings in the placentas of MAS neonates with those of meconium-stained but non-MAS neonates and to analyze the correlation between the severity of MAS and the grade of its histological parameters.

METHODS

We collected 160 singleton term placentas from neonates with meconium staining at birth from a tertiary medical center, Seoul, Republic of Korea. We reviewed hematoxylin and eosin sections of tissue samples (full-thickness placental disc, chorioamniotic membranes, and umbilical cord).

RESULTS

Funisitis was present more frequently in MAS than in non-MAS (p < .01), of which the stage was correlated with the severity of MAS (p < .001). The histological findings consistent with maternal underperfusion and chronic deciduitis were more frequent in MAS than in non-MAS (p < .05). There was a correlation between the degree of chorionic vascular muscle necrosis and the severity of MAS (p < .05).

CONCLUSIONS

Our results suggest that fetal inflammatory response evidenced by funisitis occurs prenatally in MAS and that the stage of funisitis and of chorionic vascular muscle necrosis may be a predictive marker of the severity of MAS.

摘要

背景

胎粪吸入综合征(MAS)定义为出生时伴有胎粪污染且需要补充氧气的新生儿出现呼吸窘迫。根据氧气需求,MAS在临床上分为轻度、中度和重度。本研究的目的是比较MAS新生儿胎盘与胎粪污染但无MAS新生儿胎盘的组织学发现,并分析MAS严重程度与其组织学参数分级之间的相关性。

方法

我们从韩国首尔的一家三级医疗中心收集了160例出生时伴有胎粪污染的单胎足月新生儿的胎盘。我们检查了组织样本(全层胎盘盘、绒毛羊膜和脐带)的苏木精和伊红切片。

结果

脐带炎在MAS中比在无MAS中更常见(p <.01),其中其阶段与MAS的严重程度相关(p <.001)。与母体灌注不足和慢性蜕膜炎一致的组织学发现在MAS中比在无MAS中更常见(p <.05)。绒毛膜血管肌坏死程度与MAS严重程度之间存在相关性(p <.05)。

结论

我们的结果表明,脐带炎所证明的胎儿炎症反应在MAS中发生于产前,并且脐带炎和绒毛膜血管肌坏死的阶段可能是MAS严重程度的预测指标。

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