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胎盘病理检查及其在治疗计划或患者随访中的益处:一项横断面研究。

Pathologic examination of the placenta and its benefits in treatment plan or follow-up of patients: a cross-sectional study.

机构信息

Department of Gynecologic Oncology, Vali-Asr Hospital, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex (IKHC) , Keshavarz Blvd, Tehran, Iran.

Department of Perinatalogy, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Eur J Med Res. 2022 Jul 11;27(1):113. doi: 10.1186/s40001-022-00743-7.

Abstract

BACKGROUND

The placental examination provides important information about the effect of maternal abnormalities on the placenta or the cause of preterm delivery, fetal growth restriction, or fetal neurodevelopmental damage. In this study, the frequency of placental pathologies of patients in a tertiary hospital was investigated.

METHODS

In this longitudinal and cross-sectional study, all removed placentas after any type of pregnancy termination referred to a pathological examination, within 1 year (2019-2020). All placentas were examined macroscopically and microscopically by two pathologists.

RESULTS

Unfortunately, because of the COVID-19 pandemic, the number of pregnant women in our hospital declined. A total of 258 placentas were examined. The type of delivery in 193 cases (79.4%) was cesarean section and 50 cases (20.6%) had a vaginal delivery. In the pathological assessment of placentas, 238 (92.2%) cases were normal and 20 cases (7.8%) were abnormal. Infarct and chorioamnionitis were the pathologies with higher frequencies (4.3% and 2.7%, respectively). Intra-uterine fetal death (p = 0.701), preeclampsia (p = 0.51) had no significant difference was seen in normal and abnormal placentas. Maternal age (p = 0.83), gestational age based on the last menstrual period (p = 0.38), and gestational age based on the first ultrasound (p = 0.78) did not show a significant relationship with any of the pathological complications categories.

CONCLUSIONS

Pathological examination of the placenta from all live-birth deliveries is not worthwhile, and it's recommended to modify the guidelines as to when the placenta is submitted for pathological evaluation.

摘要

背景

胎盘检查为了解母体异常对胎盘的影响或早产、胎儿生长受限或胎儿神经发育损害的原因提供了重要信息。本研究调查了一家三级医院患者的胎盘病变频率。

方法

在这项纵向和横断面研究中,所有在 1 年内(2019-2020 年)因任何类型的妊娠终止而转至病理检查的胎盘均进行了检查。两名病理学家分别对所有胎盘进行了大体和显微镜检查。

结果

不幸的是,由于 COVID-19 大流行,我院孕妇数量下降。共检查了 258 个胎盘。193 例(79.4%)分娩方式为剖宫产,50 例(20.6%)为阴道分娩。在胎盘的病理评估中,238 例(92.2%)正常,20 例(7.8%)异常。梗死和绒毛膜羊膜炎的发病率较高(分别为 4.3%和 2.7%)。宫内胎儿死亡(p=0.701)、子痫前期(p=0.51)在正常和异常胎盘之间无显著差异。产妇年龄(p=0.83)、基于末次月经的孕周(p=0.38)和基于首次超声的孕周(p=0.78)与任何病理并发症类别均无显著关系。

结论

对所有活产分娩的胎盘进行病理检查是不值得的,建议修改关于何时提交胎盘进行病理评估的指南。

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本文引用的文献

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A systematic review of placental pathology in maternal diabetes mellitus.妊娠糖尿病胎盘病理学的系统评价
Placenta. 2015 Feb;36(2):101-14. doi: 10.1016/j.placenta.2014.11.021. Epub 2014 Dec 5.
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A survey of obstetricians' views on placental pathology reporting.对产科医生胎盘病理学报告看法的调查。
Int J Gynaecol Obstet. 2013 Jun;121(3):275-7. doi: 10.1016/j.ijgo.2013.01.008. Epub 2013 Mar 13.
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Etiology of stillbirth at term: a 10-year cohort study.足月死产的病因:一项10年队列研究。
J Matern Fetal Neonatal Med. 2008 Jul;21(7):493-501. doi: 10.1080/14767050802086669.

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