Reshetnikova O S, Burton G J, Milovanov A P, Fokin E I
Department of Pathologic Anatomy, Lugansk Medical University, Ukraine.
Am J Obstet Gynecol. 1996 Feb;174(2):557-61. doi: 10.1016/s0002-9378(96)70427-1.
Our purpose was to determine the effects of pregnancy at high altitude on the human placental structure.
Histologic material from 22 term placentas delivered at altitudes above 3600 m was examined and compared with control material from 760 m.
Intraplacental chorioangiomas were identified in 5 of the 22 high-altitude placentas but in none of the 59 controls. The lesions were not visible on the external surface of the placentas and were not encapsulated. The state of differentiation varied; some contained numerous capillaries that showed sinusoidal dilations, whereas in others at the opposite extreme mesenchymal cells predominated. The presence of chorioangiomas was frequently associated with threatened premature delivery, a circumvallate placenta, and multiple infarction. The lesions represented only a small percentage of the overall placental volume (<10%).
The increased incidence of placental chorioangioma observed at high altitude (above 3600 m) may be due to the prevailing hypobaric hypoxia. Overexpression of angiogenic cytokines such as vascular endothelial growth factor, which is known to be up-regulated by this factor in vitro, may mediate this effect.
我们的目的是确定高海拔地区妊娠对人胎盘结构的影响。
检查了22例在海拔3600米以上分娩的足月胎盘的组织学材料，并与来自海拔760米的对照材料进行比较。
22例高海拔胎盘中有5例发现胎盘内绒毛膜血管瘤，而59例对照中均未发现。这些病变在胎盘外表面不可见，也没有被包裹。分化状态各不相同；一些含有大量显示窦状扩张的毛细血管，而另一些则以间充质细胞为主。绒毛膜血管瘤的存在常与先兆早产、轮状胎盘和多发性梗死相关。这些病变仅占胎盘总体积的一小部分（<10%）。
在高海拔地区（3600米以上）观察到的胎盘绒毛膜血管瘤发病率增加可能是由于普遍存在的低压缺氧。血管生成细胞因子如血管内皮生长因子的过度表达可能介导了这种效应，已知该因子在体外可被这种因素上调。
