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人胎盘组织30例,其中24例取自rivanol引产;另外6例取自剖腹取胎、钳刮取胎和水囊引产。我们从组织学和组织化学角度观察并比较这两组标本,发现rivanol引产的全部标本,其绒毛合体滋养层细胞的Δ~5-3 β-羟甾脱氢酶活性及细小脂滴明显下降;多数标本ACP酶活性升高和少数标本RNA减少。我们还发现蜕膜细胞RNA减弱;大量蜕膜细胞、少量滋养层细胞及绒毛膜板均有变性坏死;绒毛膜板有明显炎症现象以及胎盘胎儿面出现血液循环障碍。这表明rivanol对胎盘有损害作用,并使其孕酮的合成功能降低。我们认为这些影响对终止妊娠起一定的作用,并认为羊膜腔内注射rivanol的引产优于羊膜腔外注射。本文材料由北京医学院附属第三医院妇产科提供。乔根梅医师给予大力支持和帮助。特此致谢。
Thirty human placenta tissues were obtained, of which 24 were taken from rivanol abortion; the other 6 were taken from the cesarean section and the forceps were scraped to remove the fetus and induced by water sac. We observed and compared these two groups histologically and histochemically and found that Δ 5-3 β-hydroxy-desaturase activity and fine lipid droplets of all the samples of rivanol induced trophoblast cells were significantly decreased. Most specimens ACP enzyme activity increased and a few specimens of RNA decreased. We also found that decidual cell RNA was weakened; a large number of decidual cells, a small number of trophoblast cells and chorionic vasculature were degenerated and necrotic; chorionic villi had obvious inflammation and blood circulation disorder in placenta fetus. This shows that rivanol has a damaging effect on the placenta and reduces its progesterone synthesis function. We think these effects play a role in terminating pregnancy and suggest that induction of labor with intra-amniotic injection of rivanol is superior to injection with amniotic fluid. This material is provided by the Third Affiliated Hospital of Beijing Medical College Obstetrics and Gynecology. Dr. Jiao Genmei give strong support and help. Thanks so much.