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早期妊娠流产产物的测量:一项病理学研究。

Measurements in First-Trimester Abortion Products: A Pathologic Study.

机构信息

From the Surgical Sciences Domain, Medicine School (Drs Nogueira and Pinto) and the Engineering School, Department of Production and Systems (Dr Braga), Minho University, Campus de Gualtar, Braga, Portugal; the Life and Health Sciences Research Institute (ICVS), ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal (Drs Nogueira and Pinto); the Embryo-fetal Pathology Laboratory (Dr Nogueira and Mss Sousa and Azevedo) and the Prenatal Clinical Department (Dr Tavares), CGC Genetics, Porto, Portugal; the Prenatal Diagnosis Department, Hospital S Teotónio, Viseu, Portugal (Dr Pereira); the Prenatal Diagnosis Department, Hospital Tâmega Sousa, Penafiel, Portugal (Dr Carmo); and the Department of Pediatric Surgery, Hospital de S. Marcos, Braga, Portugal (Dr Pinto).

出版信息

Arch Pathol Lab Med. 2020 Feb;144(2):207-214. doi: 10.5858/arpa.2018-0181-OA. Epub 2019 Jun 11.

Abstract

CONTEXT.—: Related to the advances in prenatal diagnosis and the emergence of medically challenging situations, there has been an increased interest in conducting a pathologic study of first-trimester abortion products.

OBJECTIVE.—: To evaluate measurements across a large group of first-trimester spontaneous abortion specimens. Potential goals include a validation of prenatal embryo and gestational-sac measurements as a function of gestational age (GA).

DESIGN.—: A retrospective case study of first-trimester spontaneous abortions between June 2015 and April 2017 in Centro de Genética Clínica Embryo-Fetal Pathology Laboratory, Porto, Portugal. Considering the inclusion criteria, 585 complete gestational sacs, 182 embryos, and 116 umbilical cords were selected. We recorded the weight of the gestational sacs and embryos and measurements of gestational sacs, umbilical cords, and embryo crown-rump length. Models were computed using regression techniques.

RESULTS.—: Gestational-sac diameter percentiles 5, 25, 50, 75 and 95 were calculated according to GA, and at each 1-week interval the diameter increased an average of 3 mm. Umbilical cord length percentiles 5, 25, 50, 75 and 95 were calculated according to GA, and at each 1-week interval, the length increased an average of 1.35 mm. Embryo crown-rump length estimated mean ± SD values were GA 6 weeks, 5.3 ± 2.3 mm; GA 7 weeks, 9.4 ± 4.8 mm; GA 8 weeks, 13.7 ± 8.2 mm; GA 9 weeks, 20.8 ± 9.1 mm; GA 10 weeks, 22.6 ± 13.4 mm; GA 11 weeks, 29.4 ± 12.9 mm; and GA 12 weeks, 52 mm.

CONCLUSIONS.—: Pathologic measurements obtained should be compared to expected measurements and correlated with ultrasound findings, clinical information, and microscopic findings. Deviations from expected values could lead to an understanding of early pregnancy loss.

摘要

背景

随着产前诊断技术的进步和具有挑战性的医学情况的出现,人们对进行首例流产胚胎的病理学研究产生了浓厚的兴趣。

目的

评估首例流产标本中一组较大的测量值。潜在目标包括验证产前胚胎和妊娠囊测量值与妊娠龄(GA)的关系。

设计

这是一项葡萄牙波尔图 Centro de Genética Clínica Embryo-Fetal 病理学实验室 2015 年 6 月至 2017 年 4 月进行的首例流产回顾性病例研究。根据纳入标准,选择了 585 个完整的妊娠囊、182 个胚胎和 116 个脐带。我们记录了妊娠囊和胚胎的重量以及妊娠囊、脐带和胚胎头臀长的测量值。使用回归技术计算模型。

结果

根据 GA 计算了妊娠囊直径的第 5、25、50、75 和 95 百分位,并且每增加 1 周,直径平均增加 3 毫米。根据 GA 计算了脐带长度的第 5、25、50、75 和 95 百分位,并且每增加 1 周,长度平均增加 1.35 毫米。胚胎头臀长估计的平均值±SD 值为 GA 6 周时,5.3±2.3mm;GA 7 周时,9.4±4.8mm;GA 8 周时,13.7±8.2mm;GA 9 周时,20.8±9.1mm;GA 10 周时,22.6±13.4mm;GA 11 周时,29.4±12.9mm;GA 12 周时,52mm。

结论

获得的病理测量值应与预期测量值进行比较,并与超声检查结果、临床信息和显微镜检查结果相关联。与预期值的偏差可能会导致对早期妊娠丢失的理解。

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