Meekins J W, Pijnenborg R, Hanssens M, McFadyen I R, van Asshe A
Department of Obstetrics and Gynaecology, Liverpool Hospital, UK.
Br J Obstet Gynaecol. 1994 Aug;101(8):669-74. doi: 10.1111/j.1471-0528.1994.tb13182.x.
To investigate trophoblast invasion and vascular changes in placental bed spiral arteries in normal and severe pre-eclamptic pregnancies.
A histological and immunohistochemical study of placental bed biopsies containing spiral arteries.
The University Hospital, Leuven, Belgium.
Twenty-one placental bed biopsies from 21 normal pregnancies and 24 placental bed biopsies from 24 severe pre-eclamptic pregnancies, taken at caesarean section.
Histological and immunohistochemical appearance of spiral arteries (stained with haematoxylin and eosin), periodic acid schiff, and a monoclonal antibody to low molecular weight cytokeratin.
One hundred and twenty-seven spiral arteries were studied. In the 21 biopsies from clinically normal pregnancies at term, 100% of the decidual spiral arteries and 76% of the myometrial arteries showed trophoblast invasion. In the 24 biopsies from women with severe pre-eclampsia, trophoblast invasion was seen in 44% and 18% of the decidual and myometrial segments, respectively. Endovascular trophoblast invasion was complete, partial or isolated. A variety of morphological features was present not only in different spiral arteries from the same biopsy but also in different segments of the same artery. The vascular change most commonly associated with normal pregnancies was physiological change and subintimal thickening of both segments of the spiral arteries. In pre-eclampsia medial disorganisation and hyperplasia in the myometrial arteries and acute atherosis in decidual arteries were common.
Endovascular trophoblast did not show an all or none invasive phenomenon in normal and pre-eclamptic pregnancies. More decidual than myometrial arteries were invaded in both groups of patients, and there was a gradient in the percentage of decidual and myometrial arteries invaded from normal pregnancy to pre-eclampsia. Morphological features in one spiral artery may not necessarily be representative of all of those in a placental bed.
研究正常妊娠和重度子痫前期妊娠时胎盘床螺旋动脉的滋养层细胞浸润及血管变化。
对包含螺旋动脉的胎盘床活检组织进行组织学和免疫组织化学研究。
比利时鲁汶大学医院。
剖宫产时获取的21例正常妊娠的胎盘床活检组织和24例重度子痫前期妊娠的胎盘床活检组织。
螺旋动脉的组织学和免疫组织化学表现（苏木精-伊红染色、过碘酸希夫染色以及抗低分子量细胞角蛋白单克隆抗体染色）。
共研究了127条螺旋动脉。在21例足月临床正常妊娠的活检组织中，100%的蜕膜螺旋动脉和76%的肌层动脉有滋养层细胞浸润。在24例重度子痫前期患者的活检组织中，蜕膜段和肌层段分别有44%和18%出现滋养层细胞浸润。血管内滋养层细胞浸润可为完全性、部分性或孤立性。不仅同一活检组织的不同螺旋动脉存在多种形态学特征，同一动脉的不同节段也有多种形态学特征。与正常妊娠最常相关的血管变化是螺旋动脉两段的生理性变化和内膜下增厚。子痫前期时，肌层动脉中层结构紊乱和增生以及蜕膜动脉急性粥样硬化较为常见。
在正常妊娠和子痫前期妊娠中，血管内滋养层细胞浸润并非全有或全无的现象。两组患者中，蜕膜动脉比肌层动脉受浸润更多，从正常妊娠到子痫前期，蜕膜动脉和肌层动脉受浸润的百分比存在梯度变化。一条螺旋动脉的形态学特征不一定能代表胎盘床所有螺旋动脉的特征。
