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胎儿生长受限的母体血液学参数与胎盘和脐带组织病理学

Maternal Hematological Parameters and Placental and Umbilical Cord Histopathology in Intrauterine Growth Restriction.

机构信息

Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary,

Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary.

出版信息

Med Princ Pract. 2019;28(2):101-108. doi: 10.1159/000497240. Epub 2019 Jan 27.

Abstract

OBJECTIVE

To investigate the placental and umbilical cord histopathology in intrauterine growth restriction (IUGR) and their relation to second-trimester maternal hematological parameters.

MATERIALS AND METHODS

Patients were selected for the IUGR group based on estimated fetal weight below the 10th percentile. Patients were recruited into the control group randomly. Patients were followed up with ultrasound, and blood samples were taken between the 20th and 24th gestational weeks. After delivery and formalin fixation, weight and volume of the placenta were recorded and histologic samples were processed.

RESULTS

Maternal platelet count strongly correlates with placental weight (r = 0.766). On the other hand, neonatal weight correlates with placental volume (r = 0.572) rather than with placental weight (r = 0.469). Umbilical arterial lumen cross-sectional area correlates with birth weight (r = 0.338).

CONCLUSIONS

Maternal hematological parameters do not seem to affect neonatal outcome. Our main findings are the correlation of maternal platelet count with placental weight, the correlation of placental volume with birth weight being stronger than the correlation of placental weight with birth weight, and the correlation of umbilical artery lumen cross-sectional area with neonatal weight. Mild histopathologic alterations might occur in normal pregnancies; however, sufficient fetal nutrition can be maintained. This compensatory function of the placenta seems to be insufficient when two or more pathologies are present, which is characteristic for IUGR.

摘要

目的

研究宫内生长受限(IUGR)的胎盘和脐带组织病理学变化及其与中期妊娠母体血液学参数的关系。

材料和方法

根据估计胎儿体重低于第 10 百分位数选择 IUGR 组患者。随机招募患者进入对照组。患者在 20-24 孕周进行超声随访并采血。分娩后,固定胎盘并记录重量和体积,处理组织学样本。

结果

母体血小板计数与胎盘重量呈强相关(r = 0.766)。另一方面,新生儿体重与胎盘体积相关(r = 0.572),而不是与胎盘重量相关(r = 0.469)。脐动脉管腔横截面积与出生体重相关(r = 0.338)。

结论

母体血液学参数似乎不会影响新生儿结局。我们的主要发现是母体血小板计数与胎盘重量相关,胎盘体积与出生体重的相关性强于胎盘重量与出生体重的相关性,以及脐动脉管腔横截面积与新生儿体重的相关性。正常妊娠可能会出现轻微的组织病理学改变,但仍能维持足够的胎儿营养。当存在两种或多种病理情况时,胎盘的这种代偿功能似乎不足,这是 IUGR 的特征。

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