124例胎儿不良结局其胎盘、脐带病理与妊娠合并症并发症关系探讨

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目的:探讨引起胎儿不良结局的病因与胎盘及脐带的病理变化关系。方法:根据2003年1月~2006年12月胎儿不良结局同意做胎盘、脐带的病检124例和尸解67例,结合其病史,分析其不良结局的原因。另取12例正常新生胎盘及脐带的病检结果作对照。结果:胎儿不良结局均有胎盘及脐带不同程度的病理改变发生率为90.3%,如绒毛纤维蛋白样坏死(55.67%)、绒毛合体细胞增生(37.91%)、绒毛血管扩张(35.82%)、脐带血管堵塞(31.45%)、绒毛水肿(29.83%)、绒毛血管狭窄(25.81%)、脐带血管炎(21.78%)、绒毛发育不良(9.67%),明显高于对照组(分别为8.23%、6.85%、6.50%、5.76%、1.24%、1.02%、0.88%),P<0.01,而胎盘及脐带的病理变化大多与母亲的妊娠合并症与并发症有关。结论:胎儿不良结局其胎盘、脐带的病理改变与妊娠合并症和并发症息息相关。 Objective: To investigate the relationship between the etiology of fetal adverse outcomes and pathological changes of placenta and umbilical cord. Methods: According to the unacceptable fetal outcomes from January 2003 to December 2006, 124 cases of placenta, 67 cases of autopsy and 67 cases of umbilical cord were examined. The causes of the adverse outcomes were analyzed according to their medical history. Another 12 cases of normal neonatal placenta and umbilical cord disease test results as a control. Results: The incidences of pathological changes of placenta and umbilical cord were 90.3%, such as fibrinous necrosis (55.67%), villous somatic hyperplasia (37.91%), vasodilation (35.82%), umbilical cord (31.45%), villus edema (29.83%), villus stenosis (25.81%), umbilical vasculitis (21.78%) and villous dysplasia (9.67%) were significantly higher than those in the control group (8.23%, 6.85 %, 6.50%, 5.76%, 1.24%, 1.02% and 0.88% respectively), P <0.01. The pathological changes of placenta and umbilical cord were mostly related to the complications of pregnancy and complications of the mother. Conclusion: The pathological changes of placenta and umbilical cord in fetus with poor outcome are closely related to complications and complications of pregnancy.
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