Kurjak A, Kupesic S
Department of Obstetrics and Gynecology, Medical School University of Zagreb, Sveti Duh Hospital, Croatia.
Placenta. 1998 Nov;19(8):619-23. doi: 10.1016/s0143-4004(98)90023-6.
This study assessed yolk sac morphology and vascularity and intervillous blood flow in normal early pregnancy and missed abortion. Transvaginal colour and pulsed Doppler were used in a prospective analysis of 87 normal pregnancies and 48 missed abortions between 6 and 12 weeks gestation. The Kruskal-Wallis rank test was used to calculate the difference in yolk sac diameter and vascularity visualization rate between gestational weeks. Repeated measures analysis of variance was used for comparison of the intervillous circulation between groups. The growth of the yolk sac was considered statistically significant between gestational weeks 6 and 9, being most prominent between 9 and 10 weeks of gestation. Vascularity of the yolk sac, characterized by low velocity and absence of diastolic flow, was demonstrated in 67 per cent of normal pregnancies. Yolk sac blood flow was detected in 19 per cent of the patients with missed abortion. Doppler analysis of the intervillous circulation demonstrated decreased peak velocity of the continuous flow in patients with missed abortion for gestational weeks 11 and 12. It is concluded that progressive decrease of yolk sac vascularity coincides with visualization of more prominent colour-coded areas within the intervillous space. In patients with missed abortion, such changes do not occur.
本研究评估了正常早期妊娠和稽留流产时的卵黄囊形态、血管情况及绒毛间隙血流。采用经阴道彩色多普勒和脉冲多普勒对87例妊娠6至12周的正常妊娠和48例稽留流产进行前瞻性分析。采用Kruskal-Wallis秩和检验计算孕周之间卵黄囊直径和血管显示率的差异。采用重复测量方差分析比较各组之间的绒毛间隙循环情况。卵黄囊在妊娠6至9周之间的生长具有统计学意义，在妊娠9至10周最为显著。在67%的正常妊娠中显示出卵黄囊血管，其特征为低速且无舒张期血流。在19%的稽留流产患者中检测到卵黄囊血流。对妊娠11周和12周的稽留流产患者进行绒毛间隙循环的多普勒分析显示，连续血流的峰值速度降低。结论是，卵黄囊血管逐渐减少与绒毛间隙内更明显的彩色编码区域的显示相一致。在稽留流产患者中，不会出现这种变化。
