妊娠期糖尿病胎盘病理研究与价值  

Study and value of placental pathology in gestational diabetes mellitus

作　　者：沈健华 SHEN Jianhua(Pathology Department,Maternal and Child Health Hospital of Yunfu,Yunfu 527300,China)

机构地区：[1]云浮市妇幼保健院病理科,广东云浮527300

出　　处：《临床医学研究与实践》2023年第12期1-4,共4页Clinical Research and Practice

基　　金：云浮市医药卫生科研项目(No.2021B060)。

摘　　要：目的分析妊娠期糖尿病(GDM)产妇的胎盘病理变化以及其对妊娠结局的影响。方法选取2021年6月至2023年2月在云浮市妇幼保健院做孕前检查并分娩的GDM产妇60例作为观察组,并选取同期GDM筛查试验正常产妇60例作为对照组。比较两组的子宫动脉血流动力学参数、胎盘净重量、新生儿出生体重、胎盘系数、合体滋养细胞基底膜平均厚度、毛细血管基底膜平均厚度、胎盘绒毛形态学变化发生情况及妊娠结局。结果观察组的搏动指数(PI)、阻力指数(RI)和收缩期最大血流速度与舒张末期血流速度之比(S/D)均高于对照组,差异具有统计学意义(P<0.05)。观察组的胎盘净重量、新生儿出生体重、胎盘系数、合体滋养细胞基底膜平均厚度、毛细血管基底膜平均厚度均大于对照组,差异具有统计学意义(P<0.05)。观察组的小动脉管壁增厚管腔狭窄、绒毛成熟不良及间质毛细血管扩张充盈发生率均高于对照组,差异具有统计学意义(P<0.05)。观察组新生儿窒息、新生儿低血糖以及新生儿高总胆红素血症发生率均高于对照组,差异具有统计学意义(P<0.05)。结论GDM可影响子宫-胎盘血循环,导致胎盘病理变化,进而影响胎儿生长发育。因此,临床应加强对GDM的预防及干预,以改善产妇的妊娠结局。Objective To analyze the placental pathological changes of pregnant women with gestational diabetes mellitus(GDM)and its effect on pregnancy outcome.Methods Sixty pregnant women with GDM who underwent pre-pregnancy examination and delivered in Maternal and Child Health Hospital of Yunfu from June 2021 to February 2023 were selected as observation group,and 60 pregnant women with normal GDM screening test during the same period were selected as control group.The uterine artery hemodynamic parameters,net weight of placenta,neonatal birth weight,placental coefficient,average thickness of syncytiotrophoblast basement membrane,average thickness of capillary basement membrane,occurrence of morphological changes of placental villi and pregnancy outcomes were compared between the two groups.Results The pulsatility index(PI),resistance index(RI)and the ratio of maximum systolic blood flow velocity to end diastolic blood flow velocity(S/D)in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The net weight of placenta,neonatal birth weight,placental coefficient,average thickness of syncytiotrophoblast basement membrane and average thickness of capillary basement membrane in the observation group were greater than those in the control group,and the differences were statistically significant(P<0.05).The incidences of small artery wall thickening and iumen stenosis,poor villus maturation and interstitial capillary dilatation filling in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The incidences of neonatal asphyxia,neonatal hypoglycemia and neonatal hyperbilirubinemia in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion GDM can affect the uterine-placental blood circulation,leading to placental pathological changes,thereby affecting fetal growth and development.Therefore,clinical practice s

关 键 词：妊娠期糖尿病 胎盘 病理 妊娠结局 

分 类 号：R714.26[医药卫生—妇产科学]