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分娩或流产后新生血管病变概述

Overview of Neo-Vascular Lesions after Delivery or Miscarriage.

作者信息

Shiina Yuji

机构信息

Department of Obstetrics and Gynecology, Yamagata Prefectural Shinjo Hospital, Shinjo, 12-55 Wakabacho, Yamagata 996-0025, Japan.

出版信息

J Clin Med. 2021 Mar 5;10(5):1084. doi: 10.3390/jcm10051084.

Abstract

The concept of intrauterine neo-vascular lesions after pregnancy, initially called placental polyps, has changed gradually. Now, based on diagnostic imaging, such lesions are defined as retained products of conception (RPOC) with vascularization. The lesions appear after delivery or miscarriage, and they are accompanied by frequent abundant vascularization in the myometrium attached to the remnant. Many of these vascular lesions have been reported to resolve spontaneously within a few months. Acquired arteriovenous malformations (AVMs) must be considered in the differential diagnosis of RPOC with vascularization. AVMs are errors of morphogenesis. The lesions start to be constructed at the time of placenta formation. These lesions do not show spontaneous regression. Although these two lesions are recognized as neo-vascular lesions, neo-vascular lesions on imaging may represent conditions other than these two lesions (e.g., peritrophoblastic flow, uterine artery pseudoaneurysm, and villous-derived malignancies). Detecting vasculature at the placenta-myometrium interface and classifying vascular diseases according to hemodynamics in the remnant would facilitate the development of specific treatments.

摘要

妊娠后子宫内新血管病变的概念最初被称为胎盘息肉,现已逐渐发生变化。如今,基于诊断成像,此类病变被定义为伴有血管化的妊娠物残留(RPOC)。这些病变在分娩或流产后出现,且在附着于残留物的肌层中常伴有丰富的血管化。据报道,许多此类血管病变会在数月内自行消退。在鉴别诊断伴有血管化的RPOC时,必须考虑获得性动静脉畸形(AVM)。AVM是形态发生错误。这些病变在胎盘形成时就开始构建。这些病变不会自行消退。尽管这两种病变都被视为新血管病变,但成像上的新血管病变可能代表这两种病变以外的其他情况(例如,滋养细胞周围血流、子宫动脉假性动脉瘤和绒毛源性恶性肿瘤)。在胎盘 - 肌层界面检测血管系统,并根据残留物中的血流动力学对血管疾病进行分类,将有助于开发特定的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfb4/7961487/4f9bf4098da0/jcm-10-01084-g001.jpg

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