摘要
目的分析不同高危妊娠产妇在胎盘病理方面的差异,探讨胎盘病理检查在产科的应用价值。方法回顾性分析2016年2月～2018年2月在哈尔滨市第一医院产科住院分娩的600例高危妊娠产妇临床资料,记录产妇一般情况、胎盘病理检查结果,分析不同高危妊娠产妇在胎盘病理检查结果上存在的差异。结果 600例高危妊娠产妇的妊娠危险因素占比居前3位的是妊娠期高血压、胎盘前置、胎膜早破。600例胎盘镜下病理表现具有多样性,且以钙化灶检出率最高(67.33%,404/600),钙化灶在自然流产中发生率最低(25.61%,21/82);绒毛梗死在胎盘前置与胎盘早剥中发生率较高;合体滋养细胞结节增加在妊娠期高血压及围生儿生长受限中发生率较高;纤维蛋白物质堆积在胎膜早破、妊娠期糖尿病中发生率较高;炎症细胞浸润在自然流产与胎死宫内发生率最高,上述妊娠高危因素在各个胎盘病理中检出结果比较,差异均有统计学意义(P <0.05);绒毛血管纤维样变性在各高危因素间发生率较其他病理改变均较低,且各因素间比较,差异无统计学意义(P> 0.05)。结论高危妊娠产妇胎盘病理检查结果以钙化灶为主,妊娠危险因素不同胎盘病理检查也有差异,且镜下表现也不相同,胎盘的不同病理表现可能与妊娠结局有一定相关性,临床应重视高危妊娠产妇胎盘的病理检查。
Objective To analyze the placental pathological difference of different pregnant women with high-risk pregnancy,and to investigate the application value of placental pathological examination in the department of obstetrics. Methods The clinical data of 600 cases of high-risk pregnant women with delivery in the department of obstetrics from February 2016 to February 2018 were retrospectively studied. Placental pathological examinations were carried out after delivery. The general information and placental pathological results were recorded. The difference in the placental pathological examination of different pregnant women with high-risk pregnancy was analyzed. Results The risk factors of high-risk pregnancy among 600 high-risk pregnant women were:pregnancy-induced hypertension,placenta previa and premature rupture of membrane. 600 placentas were examined and found that their pathological manifestations were diverse,and the detection rate of calcification was the highest;600 cases of high-risk pregnant women with placental pathological examination found that calcification had the lowest incidence in spontaneous abortion;the incidence of villus infarction in placenta previa and placental abruption was higher;the increase of syncytiotrophic cell nodule had the higher incidence in gestational hypertension and perinatal growth restriction;the accumulation of fibrin material had the higher incidence in premature rupture of membrane and gestational diabetes mellitus;the incidence of inflammatory cell infiltration in spontaneous abortion and fetal death was highest;the above-mentioned pregnant high-risk factors in each placental pathology were compared,and the difference was statistically significant (P < 0.05);the incidence of villus fibrillar degeneration among the high risk factors was lower than that in other pathological changes,and there was no significant difference between the factors(P > 0.05).Conclusion The placental pathological examination results of high-risk pregnant women are mainly calcification,the different risk factors of pregnancy have different placental pathological examinations,and the microscopic manifestations are also different. The different placental pathological manifestations may be related to the pregnancy outcome. Therefore,it is necessary to pay attention to the placental pathological examination of high-risk pregnant women.
作者
杜晓艳
郭昕
Du Xiaoyan;Guo Xin(Department of Obstetrics,Harbin First Hospital,Harbin 150010,China)
出处
《中华保健医学杂志》
2019年第2期147-150,共4页
Chinese Journal of Health Care and Medicine
关键词
高危妊娠
危险因素
胎盘病理变化
High-risk pregnancy
Risk factors
Placental pathological changes
