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胎盘,婴儿发病情况的隐秘见证者:胎盘组织学与早产儿结局之间的关系

Placenta, Secret Witness of Infant Morbidities: The Relationship Between Placental Histology and Outcome of the Premature Infant.

作者信息

Çakir Ufuk, Yildiz Duran, Kahvecioğlu Dilek, Okulu Emel, Alan Serdar, Erdeve Ömer, Heper Aylin Okçu, Atasay Begüm, Arsan Saadet

机构信息

Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, ANKARA, TURKEY.

出版信息

Turk Patoloji Derg. 2019;35(1):28-35. doi: 10.5146/tjpath.2018.01443.

Abstract

OBJECTIVE

The microscopic and macroscopic features of the placenta can contribute to the clinical understanding of premature delivery. The aim of our study was to figure out the relationship between the histopathological findings of the placentas of premature deliveries and its effects on neonatal morbidity and mortality.

MATERIAL AND METHOD

The placentas of 284 singleton preterm infants with < 35 weeks of gestation were examined. Three groups were created as the normal, chorioamnionitis and vasculopathy groups according to the histopathological findings in the placentas of the subjects.

RESULTS

The mean gestational age of the infants in the study group was 30.5 ± 3.2 weeks, and the mean birth weight was 1588 ± 581 g. The pathology was normal in ninety-six (33.8%), vasculopathy in 153 (53.9%) and chorioamnionitis in 35 (12.3%). The gestation age of the infants was lower in the chorioamnionitis group. Moreover, retinopathy of prematurity, early onset neonatal sepsis, and duration of respiratory support were found to be higher in the chorioamnionitis group. In the vasculopathy group, preeclampsia and small for gestational age were found to be significantly higher.

CONCLUSION

Histopathological findings of the placentas from preterm deliveries provided important data in determining the etiology of preterm delivery and outcomes of infants. Infants delivered by mothers with chorioamnionitis were particularly found to be more preterm, and these preterm infants would have a longer hospital stay, higher respiratory support requirement, and more serious morbidities.

摘要

目的

胎盘的微观和宏观特征有助于临床理解早产。我们研究的目的是找出早产胎盘的组织病理学发现与其对新生儿发病率和死亡率的影响之间的关系。

材料与方法

检查了284例孕周小于35周的单胎早产儿的胎盘。根据受试者胎盘的组织病理学发现,分为正常组、绒毛膜羊膜炎组和血管病变组。

结果

研究组婴儿的平均孕周为30.5±3.2周,平均出生体重为1588±581g。病理正常的有96例(33.8%),血管病变的有153例(53.9%),绒毛膜羊膜炎的有35例(12.3%)。绒毛膜羊膜炎组婴儿的孕周较低。此外,绒毛膜羊膜炎组早产儿视网膜病变、早发型新生儿败血症和呼吸支持持续时间较高。在血管病变组中,子痫前期和小于胎龄儿明显较多。

结论

早产胎盘的组织病理学发现为确定早产病因和婴儿结局提供了重要数据。特别发现,患有绒毛膜羊膜炎的母亲所生的婴儿早产情况更严重,这些早产儿住院时间更长,呼吸支持需求更高,病情更严重。

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