Clair M R, Rosenberg E, Tempkin D, Andreotti R F, Bowie J D
J Ultrasound Med. 1983 Jul;2(7):297-301. doi: 10.7863/jum.1983.2.7.297.
A classification of the changes seen in the placentas of nondiabetic, non-high-risk obstetrical patients, and its relationship to fetal pulmonary maturity, has been the subject of two recent reports. Successful (100 per cent) correlation has been concluded from these studies when a Grade III placenta has been demonstrated in gestations of 33 weeks to term. To determine whether the same high degree of reliability would hold for the diabetic and high-risk obstetrical patient, 78 such patients were analyzed. All except one delivered at 33 weeks to term, and all had amniotic fluid lecithin-sphingomyelin (L/S) ratio determinations within 48 hours of sonographic placental grading and within seven days of delivery. Of the Grade III placentas (n = 13), 23 per cent had "immature" L/S ratios. However, there was no case of infantile respiratory distress syndrome (IRDS) in infants of patients with Grade III placentas. These findings suggest that placental grading may need to be part of a multifactorial assessment of fetal maturity in the diabetic or high-risk pregnancy.
关于非糖尿病、非高危产科患者胎盘变化的分类及其与胎儿肺成熟度的关系，已有两篇近期报告进行了探讨。这些研究得出结论，当在孕33周及足月妊娠中显示为Ⅲ级胎盘时，二者具有成功的（100%）相关性。为确定同样高度的可靠性是否适用于糖尿病和高危产科患者，对78例此类患者进行了分析。除1例患者外，所有患者均在33周及足月时分娩，且所有患者在超声胎盘分级后48小时内及分娩后7天内进行了羊水卵磷脂 - 鞘磷脂（L/S）比值测定。在Ⅲ级胎盘（n = 13）中，23%的患者L/S比值“不成熟”。然而，Ⅲ级胎盘患者的婴儿中未出现婴儿呼吸窘迫综合征（IRDS）病例。这些发现表明，胎盘分级可能需要成为糖尿病或高危妊娠中胎儿成熟度多因素评估的一部分。
