Wang T
Placenta. 1981 Jan-Mar;2(1):35-43. doi: 10.1016/s0143-4004(81)80038-0.
Human amniotic epithelium from patients with normal pregnancy (normal amniotic epithelium) and from patients with materno-fetal rhesus incompatibility has been examined under the light and electron microscope. In comparison with normal amniotic epithelium, the epithelium in rhesus incompatibility displays the following morphological changes: 1. Unequal distribution and variable shape of the plump microvilli 2. Considerable narrowing of the intercellular spaces 3. Vacuolization of the cytoplasm 4. Absence of glycogen granules 5. Thickening of the basal membrane. There is a direct correlation between the morphological changes in the amniotic epithelium and the severity of the disease. Since rhesus factors are present only in erythrocytes, it is probably that these changes are not based on a direct immune conflict. On the contrary, they are more likely due to fetal hypoxia and to the cytotoxic effect of unbound, unconjugated bilirubin in the amniotic fluid.
对正常妊娠患者（正常羊膜上皮）和母胎恒河猴血型不相容患者的人羊膜上皮进行了光镜和电镜检查。与正常羊膜上皮相比，恒河猴血型不相容时的上皮呈现以下形态学变化：1. 丰满微绒毛分布不均且形状各异；2. 细胞间隙显著变窄；3. 细胞质空泡化；4. 糖原颗粒缺失；5. 基底膜增厚。羊膜上皮的形态学变化与疾病严重程度之间存在直接关联。由于恒河猴因子仅存在于红细胞中，这些变化可能并非基于直接的免疫冲突。相反，它们更可能是由于胎儿缺氧以及羊水中未结合、未共轭胆红素的细胞毒性作用所致。
