妊娠期糖尿病胎盘超微结构与胎儿生长异常的关系  

The relationship between the placental ultrastructures in gestational diabetes mellitus and abnormal fetal growth

作　　者：米阳[1] 郭娜 黄谱[1] 苟文丽[1] 

机构地区：[1]西安交通大学医学院第一附属医院妇产科,陕西西安710061 [2]陕西省妇幼保健院,陕西西安710061

出　　处：《中国实用妇科与产科杂志》2010年第12期936-939,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：陕西省科技攻关项目(2008K14-04)

摘　　要：目的探讨妊娠期糖尿病(GDM)并发巨大儿与胎儿生长受限(FGR)患者胎盘超微结构的改变。方法选取2009-2010年陕西省妇幼保健院住院足月剖宫产分娩孕妇15例胎盘组织,进行电镜观察其超微结构改变,其中8例为GDM合并巨大儿胎盘,4例为GDM并发FGR胎盘,3例为正常孕妇胎盘。结果 GDM合并巨大儿患者胎盘超微结构改变表现为微绒毛排列紊乱,部分缺失,线粒体、粗面内质网等细胞器肿胀受损;毛细血管增生,基底膜增厚。GDM合并FGR患者的胎盘超微结构改变表现为微绒毛稀疏细小,细胞核不规则;细胞质内有较多的空泡,细胞器数量减少;毛细血管减少。结论 GDM患者胎盘形态学改变可能直接影响了胎盘的供血和供氧功能,导致了不良妊娠结局。Objective To study the placental ultrastructural changes in gestational diabetes mellitus（GDM）complicated with fetal macrosomia and fetal growth restriction.Methods Three normal pregnant women,eight women with gestational diabetes mellitus complicated with fetal macrosomia,and four women with gestational diabetes mellitus complicated with fetal growth restriction were selected in the research.The placental ultrastructures were studied under electron microscope.Results The GDM placentas complicated with fetal macrosomia showed the microvilli on the surface of syncytiotrophoblast cells became deranged and excalation,with the Organelles swollen and damaged.There was capillary proliferation,uneven thickening of basement membrane.The GDM placentas complicated with fetal growth restriction showed the microvilli on the surface of syncytiotrophoblast cells became rarefaction and extenuation,decreased in number of Organelles and capillary.Conclusion The pathologic changes of GDM may directly affect the placental blood and oxygen supply and result in problem pregnancies.

关 键 词：妊娠期糖尿病 巨大儿 胎儿生长受限 胎盘 超微结构 

分 类 号：R71[医药卫生—妇产科学]