单胎胎盘形状异常及脐带附着部位异常的病理学检查特点及其可能对妊娠结局的影响  

Pathological Examination Features of Abnormal Placental Shape and Abnormal Umbilical Cord Attachment in Singleton Pregnancies and Their Possible Impact on Pregnancy Outcomes

作　　者：袁华领 代海平 YUAN Hualing;DAI Haiping(Department of Pathology,Pingqiao District Maternity and Child Health Hospital,Xinyang Henan 464000,China;Department of Pathology and Gynecology,Xiamen Maternity and Child Health Hospital,Xiamen,Fujian 361003,China)

机构地区：[1]河南省信阳市平桥区妇幼保健院病理科,河南信阳464000 [2]厦门市妇幼保健院病理科妇科,福建厦门361003

出　　处：《临床研究》2025年第3期129-131,共3页Clinical Research

摘　　要：目的分析单胎胎盘形状异常及脐带附着部位异常的病理学检查特点及其可能对妊娠结局的影响。方法选取河南省信阳市平桥区妇幼保健院病理科2021年1月至2023年5月送检的胎盘形状异常及脐带附着部位异常的单胎胎盘80例,对其病理学特点进行回顾性总结分析,同时探讨其可能对妊娠结局的影响。结果全部80例胎盘形状异常及脐带附着部位异常的单胎胎盘中,伴随的胎儿不良结局情况为早产27例、生长受限14例、宫内窘迫11例、死胎1例;伴随的产妇不良结局情况为前置胎盘5例、胎盘早剥2例、胎膜早破30例。全部80例形态异常的单胎胎盘组织中,2例为不规则胎盘,2例为脐带帆状附着,3例为球拍状胎盘,7例为异常胎膜内血管,8例为轮廓胎盘,28例为有缘胎盘,30例为副叶胎盘;不同类型胎盘的大体特点各不相同。镜下检查结果显示,全部80例胎盘形状异常及脐带附着部位异常的单胎胎盘的主要变化在功能性形态学方面,主要表现为母胎血管灌注不良,而具体表现主要为绒毛过度成熟、远端绒毛发育不良、绒毛梗死等。结论胎盘形状异常及脐带附着部位异常的单胎胎盘大体特点各不相同,母胎血管灌注不良,可能会导致早产儿、胎死宫内、胎儿宫内窘迫、胎儿宫内生长受限、胎膜早破、胎盘早剥、前置胎盘等不良妊娠结局。Objective To analyze the pathological examination features of abnormal placental shape and abnormal umbilical cord attachment in singleton pregnancies and their possible impact on pregnancy outcomes.Methods We selected 80 cases of singleton placentas with abnormal shape and umbilical cord attachment referred to the Department of Pathology at Pingqiao District Maternity and Child Health Hospital in Xinyang,Henan,from January 2021 to May 2023.A retrospective summary analysis was conducted on their pathological features,and a discussion on their possible impact on pregnancy outcomes was undertaken.Results Among the 80 singleton placentas with abnormal shape and umbilical cord attachment,the associated adverse fetal outcomes included 27 preterm births,14 cases of growth restriction,11 cases of intrauterine distress,and 1 stillbirth.The maternal adverse outcomes included 5 cases of placenta previa,2 cases of placental abruption,and 30 cases of premature rupture of membranes.Among all 80 cases of morphologically abnormal singleton placentas,there were 2 cases of irregular placentas,2 cases of membranous umbilical cord attachment,3 cases of discoid placenta,7 cases of abnormal intramembranous vessels,8 cases of circumvallate placenta,28 cases of marginal placenta,and 30 cases of accessory lobe placenta;the gross features varied significantly among the different types of placentas.Microscopic examination revealed that the main changes in all 80 singleton placentas with abnormal shape and umbilical cord attachment were related to functional morphology,primarily characterized by poor maternal-fetal vascular perfusion,specifically evidenced by chorionic villous hypermaturity,distal villous dysplasia,and villous infarction.Conclusion The gross characteristics of singleton placentas with abnormal shape and abnormal umbilical cord attachment are different,and poor maternal-fetal vascular perfusion may lead to adverse pregnancy outcomes such as preterm birth,intrauterine fetal demise,fetal distress,intrauterine growth restricti

关 键 词：单胎胎盘 形状异常 病理学检查特点 妊娠结局 

分 类 号：R4[医药卫生—临床医学]