超声诊断胎儿生长受限相关胎盘疾病的研究进展  

Research progress of ultrasound in the diagnosis of placental diseases related to fetal growth restriction

作　　者：玄英华[1] 张娜[1] 吴青青[1] 王莉[1] XUAN Yinghua;ZHANG Na;WU Qingqing;WANG Li(Department of Ultrasound,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,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,北京市100026

出　　处：《临床超声医学杂志》2023年第5期405-410,共6页Journal of Clinical Ultrasound in Medicine

基　　金：国家自然科学基金项目(22006103)。

摘　　要：胎儿生长受限(FGR)可能增加胎儿和新生儿死亡风险,与新生儿并发症、儿童期认知发育迟缓和成年期疾病紧密相关。FGR的主要病因包括母体、胎儿和胎盘因素3个方面,其中胎盘因素是导致FGR的最主要原因。胎盘早期发育异常如螺旋动脉重塑异常导致的母体血管灌注不良是导致FGR的最常见胎盘原因。此外,一些特殊的胎盘疾病,如胎盘绒毛膜板下出血、胎盘间叶发育不良常会并发FGR,三倍体胎儿也常同时合并FGR、胎儿结构畸形及胎盘异常改变。产前结合胎盘的超声表现有助于明确FGR的病因,对FGR的产前处理有重要意义。本文就上述多种FGR相关胎盘疾病的发病机制、病理基础,以及其相应超声表现进行综述。Fetal growth restriction(FGR)is associated with increased fetal and neonatal morbidity and mortality,recognition disorders in childhood,and some diseases of adults.The etiology of FGR mainly includes maternal,fetal and placental aspects,and placental disorders are the main causes of FGR.The most common placental factor related to FGR is maternal vascular malperfusion,which is caused by remodeling abnormality of spiral arteries in the first trimester.In addition,some rare placental disorders,such as subchorionic hematoma,placental mesenchymal dysplasia are also associated with FGR.Triploid fetuses are often accompanied by FGR,fetal structural abnormalities and placental abnormalities.Prenatal ultrasound detection of placental anomalies can assist in clarifying the etiology of FGR,and is of great significance for appropriate antenatal management of FGR.This paper reviews the etiology,pathology and ultrasound features of placental disorders associated with FGR.

关 键 词：超声检查 胎儿生长受限 胎盘 灌注不良 三倍体 绒毛膜板下出血 间叶发育不良 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]