Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
J Ultrasound Med. 2019 Jul;38(7):1791-1796. doi: 10.1002/jum.14868. Epub 2018 Nov 27.
The influence of placental morphologic characteristics on pregnancy outcomes is poorly understood. Our objective was to evaluate the relationship of the distance of the placental cord insertion from the placental edge (PCI-D) with associated placental characteristics as well as birth outcomes.
We performed a retrospective cohort study of nulliparous women with singleton gestations undergoing obstetric ultrasound examinations between 14 and 23 weeks' gestation with a cervical length of greater than 3.0 cm who delivered between 24 and 42 weeks. A 3-dimensional volume of the placenta was evaluated. The PCI-D was obtained with Virtual Organ computer-aided analysis software (GE Healthcare, Milwaukee, WI). Generalized linear regression and generalized additive models were fitted to explore the associations between the PCI-D in relation to demographic and clinical characteristics.
A total of 216 pregnancies were included in the analysis. The PCI-D did not correlate with maternal age, gestational age at delivery, mode of delivery, or 5-minute Apgar score. Although not statistically significant, the birth weight z score (P = .09) was associated with a longer PCI-D, and gravidity was associated with a shorter PCI-D (P = .10). A low-lying placenta or placenta previa was associated with a longer PCI-D (P = .03).
The PCI-D is associated with a low placental position in the second trimester. These data are helpful for understanding placental development. The PCI-D may be associated with pregnancy-related factors such as birth weight and multigravidity. More research is required to evaluate the effects of pregnancy-related factors on the PCI-D and the effect of the PCI-D on pregnancy outcomes.
胎盘形态特征对妊娠结局的影响尚未明确。本研究旨在评估胎盘脐带附着位置距胎盘边缘的距离（PCI-D）与胎盘特征及分娩结局的关系。
我们对 24 至 42 孕周间、经阴道超声检查宫颈长度＞3.0cm、单胎妊娠、初产妇的超声资料进行了回顾性队列研究。应用三维容积超声技术对胎盘进行评估，采用虚拟器官计算机辅助分析软件（GE Healthcare，Milwaukee，WI）获取 PCI-D。采用广义线性回归和广义加性模型拟合分析 PCI-D 与人口统计学及临床特征的关系。
共纳入 216 例妊娠，PCI-D 与产妇年龄、分娩时的孕龄、分娩方式或 5 分钟 Apgar 评分均无相关性。出生体重 z 值虽无统计学差异（P＝.09），但与 PCI-D 较长有关，而产次与 PCI-D 较短有关（P＝.10）。低置胎盘或前置胎盘与 PCI-D 较长有关（P＝.03）。
在妊娠中期，PCI-D 与胎盘位置较低有关。这些数据有助于理解胎盘的发育。PCI-D 可能与与妊娠相关的因素如出生体重和多胎妊娠有关。还需要更多的研究来评估妊娠相关因素对 PCI-D 的影响以及 PCI-D 对妊娠结局的影响。
