摘要
目的探讨胎盘内异常血池超声声像特征与临床妊娠结局的相关性。方法选择在我院产前超声检查发现有胎盘内异常血池声像的孕产妇100例作为观察组,并根据胎盘血池大小分为胎盘血池>10 cm组40例、胎盘血池≤10 cm组60例;另选择同期无胎盘内异常血池声像的孕产妇100例作为对照组,并对100例异常血池的胎盘进行了病理检查,比较两组孕产妇的妊娠结局,观察胎盘异常血池病例中胎盘的病理情况。结果观察组中胎盘血池>10 cm组的孕产妇的早产率、产后出血率、胎盘早剥率、剖宫产率、胎儿生长受限发生率均高于胎盘血池≤10 cm组的孕产妇,差异有统计学意义(P<0.05),而胎盘血池≤10 cm组的孕产妇的临床妊娠结局与对照组孕产妇的临床妊娠结局相比差异无统计学意义(P>0.05);观察组中胎盘血池>10 cm组胎盘发生绒毛膜板下血栓形成或局部梗死、绒毛纤维素样变或纤维素样沉积、炎症细胞浸润(绒毛膜羊膜炎)者明显高于胎盘血池≤10 cm组,差异有统计学意义(P<0.05)。结论持续存在且胎盘血池>10 cm对母婴妊娠结局具有一定的不良影响,胎盘血池>10 cm可成为胎儿生长受限、胎盘早剥、产后出血的原因之一。应动态监测胎盘血池大小,加强宫内胎儿的实时监测,评估母婴情况、及时处理、改善预后,降低不良结局的发生率。
Objective To investigate the correlation between the ultrasonographic characteristics of abnormal placental lakes(PLs)and clinical pregnancy outcomes.Methods As for the research group,100 pregnant women in our hospital with ultrasonic images of abnormal PLs identified by prenatal ultrasonography were selected.Based on the PLs’sizes,they were further classified as the PL>10 cm group and the PL≤10 cm group(n=40 and 60,respectively).Additional 100 pregnant women without ultrasonic images of abnormal PLs in the same period were set as the control group.Pathological examinations were performed on the placental tissues of the research group.The pregnancy outcomes between the two groups were compared,and the pathological changes in the placenta tissues in the research group were observed.Results In comparison with the PL≤10 cm group,the PL>10cm group was observed with significantly higher rates of preterm delivery,postpartum hemorrhage,placental abruption,cesarean delivery,and fetal growth restriction(FGR,all P<0.05),whereas,the control group had no significant differences by comparisons in terms of clinical pregnancy outcomes(all P>0.05).When compared with the PL≤10 cm group,the PL>10 cm group had significantly more cases that developed subchorionic plate thrombosis or local infarction,villous cellulose degeneration or cellulose-like deposits,inflammatory cell infiltration(chorioamnionitis,all P<0.05).Conclusion The persistent existence of PL>10 cm has negative impacts on the maternal and fetal pregnancy outcomes,and may cause FGR,placental abruption,and postpartum hemorrhage.Dynamic monitoring of PL size,intensive real-time monitoring of the fetus,proper assessment,and prompt reaction is warranted to improve prognosis and to reduce the incidence of adverse outcomes.
作者
李玲
张文琴
张盼盼
吕小勇
仇玮
吴丹
张玲玲
LI Ling;ZHANG Wenqin;ZHANG Panpan;LYU Xiaoyong;QIU Wei;WU Dan;ZHANG Lingling(Department of Ultrasound,Jiangning Hospital Affiliated to Nanjing Medical University,Nanjing 211100,China;Department of Obstetrics and Gynecology,Jiangning Hospital Affiliated to Nanjing Medical University,Nanjing 211100,China;Department of Pathology,Jiangning Hospital Affiliated to Nanjing Medical University,Nanjing 211100,China)
出处
《医学影像学杂志》
2023年第10期1849-1852,共4页
Journal of Medical Imaging
基金
江苏省南京市江宁区第四批科技发展计划惠民计划项目(编号:2020SHSY0099)。
关键词
胎盘血池
胎盘病理
妊娠结局
动态监测
超声检查
Placental blood pool
Placental pathology
Pregnancy outcome
Dynamic monitoring
Ultrasonic examination
