Mondal Tanima Roy, Bandyopadhyay Goutam, Mukhopadhyay Sabuj Ghana, Ganguly Dyuti
Pathologist, MR Bangur Superspeciality Hospital, KOLKATA, WEST BENGAL, INDIA.
Turk Patoloji Derg. 2019;35(2):107-118. doi: 10.5146/tjpath.2018.01444.
Meconium passage during labour is a quite common finding. Studies describing correlation between meconium stained liquor, fetal distress and specific placental pathology are sparse. This case control study had been designed to ascertain these lacunae of knowledge.
Placentae from 41 cases of otherwise uncomplicated antenatal and intranatal pregnancies with meconium stained liquor at 37 completed weeks of gestation were studied, both grossly and microscopically, comparing them with controls of 41 cases of clear liquor. Apgar score of all newborns at 1 minute and 5 minutes were recorded and correlated with histopathological findings.
Both cases and controls were found to be age matched. Meconium stained liquor was associated with more caesarian section than the clear ones. Significant correlation was found with meconium stained liquor and low Apgar scores. Histopathology of placenta revealed many statistically significant associations between specific placental histopathology in meconium stained liquor and depressed Apgar score. Evidence of placental vasculopathy rather than meconium induced placental damage came out as the potential culprit in causing a low Apgar score in this case control study.
Placental vascular changes have a role in meconium staining of liquor. If timely interventions are taken, the chance of development of fetal distress is low.
分娩时出现胎粪排出是一种相当常见的现象。描述羊水胎粪污染、胎儿窘迫与特定胎盘病理之间相关性的研究较少。本病例对照研究旨在填补这些知识空白。
对41例妊娠37周足月、产前及产时无其他并发症且羊水胎粪污染的胎盘进行大体和显微镜检查，并与41例羊水清亮的对照胎盘进行比较。记录所有新生儿1分钟和5分钟时的阿氏评分，并将其与组织病理学结果进行关联分析。
发现病例组和对照组年龄匹配。羊水胎粪污染组剖宫产率高于羊水清亮组。羊水胎粪污染与低阿氏评分之间存在显著相关性。胎盘组织病理学显示，羊水胎粪污染时特定胎盘组织病理学与低阿氏评分之间存在许多具有统计学意义的关联。在本病例对照研究中，胎盘血管病变而非胎粪引起的胎盘损伤被证明是导致低阿氏评分的潜在原因。
胎盘血管变化在羊水胎粪污染中起作用。如果及时采取干预措施，胎儿窘迫发生的几率较低。
