胎盘病理结果对胎儿窘迫病因的分析及预防  

Analysis and Prevention of the Pathological Results of Placenta on the Etiology of Fetal Distress

作　　者：颜珊 李清春 YAN Shan;LI Qing-chun(Binzhou Medical College Clinical College,Binzhou,Shandong Province,256603 China;Department of Obstetrics,Chengyang District People's Hospital,Qingdao,Shandong Province,266100 China;Department of Reproductive Medicine,Affiliated Hospital of Binzhou Medical College,Binzhou,Shandong Province,256603 China)

机构地区：[1]滨州医学院临床医学院,山东滨州256603 [2]城阳区人民医院产科,山东青岛266100 [3]滨州医学院附属医院生殖医学科,山东滨州256603

出　　处：《系统医学》2020年第24期10-12,27,共4页Systems Medicine

摘　　要：目的从胎盘病理角度分析胎儿窘迫发生原因,寻找预防胎儿窘迫方法。方法回顾性分析2019年1-12月在城阳区人民医院分娩诊断为胎儿窘迫且胎盘送病理的病例188例,记录产妇病例情况、胎盘病理结果。分析胎盘病理结果中绒毛膜羊膜炎、胎盘梗死、胎盘钙化占比例。对于诊断为绒毛膜羊膜炎病例,从胎膜破裂距分娩时间(以10 h、18 h为分界点),寻找绒毛膜羊膜炎的高危因素。分析合并妊娠期高血压疾病、妊娠期糖尿病病例中病情控制差异对胎儿窘迫发病率、胎盘病理中梗死、钙化变化的影响。结果胎儿窘迫胎盘病例中患有绒毛膜羊膜炎比例为84.57%,其中有临床表现占22.01%;胎膜破裂距离分娩时间超过18 h发生绒毛膜羊膜炎比例最高(95.45%),该发病时间对比其他时间段差异有统计学意义(P<0.05)。在胎儿窘迫合并妊娠期高血压疾病中子痫前期-子痫的发病率高于妊娠期高血压,妊娠期高血压疾病组间钙化发生率比较差异有统计学意义(P<0.05),梗死发生率比较差异无统计学意义(P>0.05)。妊娠期糖尿病中糖化血红蛋白≥5.5%发病率高于糖化血红蛋白<5.5%。但梗死及钙化发生率差异无统计学意义(P>0.05)。结论发生胎儿窘迫病例的胎盘病理中绒毛膜羊膜炎为主要病变,发生绒毛膜羊膜炎几率随胎膜破裂时间延长而增大,有效控制妊娠期并发症可减少胎儿窘迫发生率。Objective To analyze the causes of fetal distress from the perspective of placenta pathology,and to find ways to prevent fetal distress.Methods A retrospective analysis of 188 cases of fetal distress and placental pathology diagnosed during delivery at Chengyang District People's Hospital in Qingdao from January to December 2019 were retrospectively analyzed.Maternal cases and placental pathological results were recorded.Analyze the proportions of chorioamnionitis,placental infarction and placental calcification in the results of placenta pathology.For cases diagnosed with chorioamnionitis,the time between fetal membrane rupture and delivery(with 10 h and 18 h as the dividing point),looking for high-risk factors for chorioamnionitis.Analyze the effects of differences in disease control in cases of gestational hypertension and gestational diabetes on the incidence of fetal distress,infarction and calcification changes in placental pathology.Results The proportion of fetal distress placenta cases with chorioamnionitis was 84.57%,of which 22.01%had clinical manifestations;the rupture of the fetal membranes occurred more than 18 h after delivery,the highest proportion of chorioamnionitis(95.45%),the time of the onset had differences compared with other time periods,the difference was statistically significant(P<0.05).The incidence of preeclampsia and eclampsia in fetal distress combined with pregnancy-induced hypertension was higher than that of pregnancy-induced hypertension.The difference in the incidence of calcification between the pregnancy-induced hypertension groups was statistically significant(P<0.05),and the occurrence of infarction There was no statistically significant difference in rates(P>0.05).The incidence of glycosylated hemoglobin≥5.5%in gestational diabetes is higher than that of glycosylated hemoglobin<5.5%.However,there was no significant difference in the incidence of infarction and calcification(P>0.05).Conclusion Chorioamnionitis is the main pathology in the placental pathology of fetal dist

关 键 词：胎盘病理 胎儿窘迫 绒毛膜羊膜炎 妊娠期高血压疾病 妊娠期糖尿病 

分 类 号：R779[医药卫生—眼科]