Vaillant P, Best M C, Cynober E, Devulder G
Service de Gynécologie-Obstétrique, CHG, Creil.
J Gynecol Obstet Biol Reprod (Paris). 1993;22(3):301-7.
We carried out a retrospective study on 96 patients whose uterine waveforms were abnormal, in order to determine if a laterally located placenta further increased this risk. Our population was separated into 2 groups (75 women with a laterally located placenta, 21 with a centrally located placenta). We have found a significant difference between ipsi placental uterine blood flow velocity and contralateral placental blood flow velocity when the placenta is located laterally, where as the 2 arteries are similar when the placenta has a central location. The following factors were used to compare the two groups: the patient's previous obstetric record and the incidence of hypertensive disorders and fetal distress. In the group with laterally located placentas, the incidence of complications in previous pregnancies was higher, hypertension was more frequently serious or presented complications, fetal distress and cesarean sections were more frequent as was IUGR. All cases of intrauterine death were found in the group with laterally located placentas. In determining the predictive value of the "laterally located placenta" test, we found in the centrally located placenta group that hypertensive disorders were often less serious and less frequently complicated by albuminuria, that the outcome of pregnancy disorders was less serious for the fetus, and that the neonate was less hypotrophic. No incidence of intrauterine death was recorded for the centrally located group. Placental laterality significantly increases both the frequency and the seriousness of fetomaternal hypertensive disorders.
我们对96例子宫波形异常的患者进行了一项回顾性研究，以确定胎盘位于侧方是否会进一步增加这种风险。我们的研究对象被分为两组（75例胎盘位于侧方的女性，21例胎盘位于中央的女性）。我们发现，当胎盘位于侧方时，同侧胎盘子宫血流速度与对侧胎盘血流速度之间存在显著差异，而当胎盘位于中央时，两条动脉的血流速度相似。我们使用以下因素对两组进行比较：患者既往的产科记录、高血压疾病的发生率以及胎儿窘迫的发生率。在胎盘位于侧方的组中，既往妊娠并发症的发生率更高，高血压更常为重度或出现并发症，胎儿窘迫和剖宫产更频繁，胎儿生长受限也更常见。所有宫内死亡病例均出现在胎盘位于侧方的组中。在确定“胎盘位于侧方”这一检测的预测价值时，我们发现，在胎盘位于中央的组中，高血压疾病往往不太严重，蛋白尿并发症较少，妊娠疾病对胎儿的影响不太严重，新生儿发育不良的情况也较少。胎盘位于中央的组未记录到宫内死亡病例。胎盘的位置偏向显著增加了母胎高血压疾病的发生率和严重程度。
