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[妊娠中期晚期流产胎儿及胎盘的形态学发现]

[Morphologic findings in fetuses and placentas of late abortion in the 2nd trimester].

作者信息

Emmrich P, Horn L C, Seifert U

机构信息

Institut für Pathologie der Universität Leipzig.

出版信息

Zentralbl Gynakol. 1998;120(8):399-405.

PMID:9757547
Abstract

To investigate possible causes of abortion (and intrauterine foetal death) we reviewed clinical and morphological data of foetuses and placentas morphologically from 830 spontaneous abortions seen during a 12 years period (1978-1989) at the Institute of Pathology, University of Leipzig, and the Pathological Institute of Hoyerswerda. Our review showed that definite and possible causes of foetal death and abortion could be classified as placental, foetal maternal, and clinical. Placental changes, which included infection of the foetal membranes, disturbances of the uteroplacental circulation (abruptio placentae with bleeding) and placental dysmaturity, were the most important causes and accounted for 73.8% of the cases. Foetal causes mainly comprised multiple twin pregnancies and foetal malformations. In 20 cases (2.4%) we found malformations as a cause of foetal death and consecutive abortion. Overall, malformations were found in 7.5% of the cases examined. Maternal and obstetric complications of pregnancy were less frequent. In 16.5% of our cases, the cause of the abortion or intrauterine death remained obscure. However, since 1989, genetic analysis and prenatal diagnostic procedures have improved, bringing a greater knowledge on the spectrum and aetiology of possible developmental disorders in the foetus. This should reduce the number of unexplained abortions.

摘要

为了探究流产(及宫内胎儿死亡)的可能原因,我们回顾了1978年至1989年这12年间在莱比锡大学病理研究所和霍耶斯韦达病理研究所见到的830例自然流产胎儿及胎盘的临床和形态学数据。我们的回顾显示,胎儿死亡和流产的确切及可能原因可分为胎盘因素、胎儿-母体因素和临床因素。胎盘变化,包括胎膜感染、子宫胎盘循环障碍(胎盘早剥伴出血)和胎盘成熟障碍,是最重要的原因,占病例的73.8%。胎儿因素主要包括多胎妊娠和胎儿畸形。在20例(2.4%)中,我们发现畸形是胎儿死亡及随后流产的原因。总体而言,在所检查的病例中,7.5%存在畸形。妊娠的母体和产科并发症较少见。在我们的病例中,16.5%的流产或宫内死亡原因不明。然而,自1989年以来,基因分析和产前诊断程序有所改进,使人们对胎儿可能发育障碍的范围和病因有了更多了解。这应该会减少不明原因流产的数量。

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