先天性心脏病胎儿胎盘病理学改变  

Pathological changes of placenta in fetuses with congenital heart disease

作　　者：熊晓蔚 吴青青[1] 张思敏 王晶晶[1] XIONG Xiaowei;WU Qingqing;ZHANG Simin;WANG Jingjing(Department of Ultrasound,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing Maternal and Child Health Care Hospital,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院、北京妇幼保健院超声科,北京100026

出　　处：《中国医学影像技术》2023年第3期397-400,共4页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金项目(81971619)。

摘　　要：目的探讨先天性心脏病(CHD)胎儿胎盘的病理学改变。方法回顾性分析89胎CHD胎儿(CHD组)及111胎正常胎儿(对照组)的产前超声资料、胎盘病理检查结果及相关临床资料,观察组间胎盘病理改变、胎盘质量(P wt)、胎儿出生或引产时体质量(B wt)及P wt/B wt比值的差异。结果CHD组胎盘炎症2级、脐血管炎、合体细胞结节增多、边缘型脐带胎盘插入及单脐动脉发生率均高于、而钙化灶发生率及成熟胎盘比例均低于对照组(P均<0.05)。CHD组P wt、B wt均低于、而P wt/B wt比值高于对照组(P均<0.05)。CHD组7.87%(7/89)胎儿P wt/B wt比值大于对应孕周P wt/B wt比值第90百分位,对照组为1.80%(2/111),组间差异有统计学意义(P<0.05)。结论CHD胎儿胎盘存在灌注不良、高级别胎盘炎症及功能不全等病理学改变。Objective To investigate the pathological changes of placenta in fetuses with congenital heart disease(CHD).Methods Totally 89 CHD fetuses(CHD group)and 111 normal fetuses(control group)were enrolled.Prenatal ultrasound,placental pathological examination and related clinical data were retrospectively analyzed,and placental pathological changes,placental weight(P wt),birth weight(B wt)and P wt/B wt ratio were compared between groups.Results The incidences of placental inflammation grade 2,umbilical angiitis,increased syncytial knots,marginal placental cord insertion and single umbilical artery in CHD group were all higher than those in control group(all P<0.05),while of calcification and mature placenta in CHD group were lower than those in control group(both P<0.05).P wt and B wt of CHD group were lower than those of control group(both P<0.05),while P wt/B wt ratio of CHD group was higher than that of control group(P<0.05).The P wt/B wt ratio greater than the 90th percentile P wt/B wt for relative gestational age was 7.87%(7/89)in CHD group and 1.80%(2/111)in control group,respectively,and the difference between groups was significant(P<0.05).Conclusion Pathological changes of placenta in CHD fetuses included poor perfusion,grade 2 inflammation and dysfunction.

关 键 词：胎儿心脏 先天性畸形 胎盘 超声检查 产前 病理学 

分 类 号：R714.53[医药卫生—妇产科学] R445.1[医药卫生—临床医学]