Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
University of Texas Southwestern Medical School, Dallas, TX, USA.
Front Endocrinol (Lausanne). 2022 Sep 8;13:920680. doi: 10.3389/fendo.2022.920680. eCollection 2022.
To determine the birth prevalence of perinatal stroke in term born infants at our high-volume delivery center and assess the frequency of both gross and histologic placental pathologies associated with perinatal stroke using the Amsterdam Placental Workshop Group Consensus Statement guidelines and definitions.
A single-center retrospective cohort study spanning 2010-2020.
There were 129,759 live births at Parkland Hospital during the study period and a total of 18 term born infants leading to a birth prevalence of 1 in 6,829 infants. Perinatal risk factors were found in all but one patient, and 74% presented with seizures. Pathologic placental examination was available in 56% of the cohort and only one patient had normal placental examination. Acute histologic chorioamnionitis was described in five placentas (50%) and an additional two had isolated umbilical and/or chorionic plate vasculitis with or without funisitis compared to a rate of 28% with acute inflammation in a Control group. Chronic inflammation in the form of villitis of unknown etiology was described in three of the acutely inflamed placentas and was high-grade in each of those while none of the placentas from our Control group showed evidence of any chronic lesion.
Both acute and chronic placental inflammation are common in perinatal stroke; placental examination should be considered an essential component to the diagnostic workup.
在我们的大容量分娩中心确定足月出生婴儿围产期卒中的发病流行率，并根据阿姆斯特丹胎盘工作组共识声明指南和定义评估与围产期卒中相关的大体和组织学胎盘病变的频率。
一项跨越 2010 年至 2020 年的单中心回顾性队列研究。
在研究期间，帕克兰医院共有 129759 例活产，共有 18 例足月出生婴儿，发病率为每 6829 例婴儿中 1 例。除 1 例患者外，所有患者均存在围产期危险因素，且 74%的患者出现癫痫发作。56%的患者进行了病理胎盘检查，仅 1 例患者的胎盘检查正常。五例胎盘（50%）出现急性组织学绒毛膜羊膜炎，另外两例胎盘伴有或不伴有脐带炎和/或绒毛膜板血管炎，而对照组中急性炎症的发生率为 28%。在急性炎症的 3 例胎盘中有 3 例出现了未知病因的绒毛炎，且每个胎盘均为高级别炎症，而对照组的胎盘均未显示任何慢性病变的证据。
围产期卒中中急性和慢性胎盘炎症均很常见；胎盘检查应被视为诊断评估的重要组成部分。
