CAJ | 학술논문

目的探讨小于胎龄儿(SGA)与胎盘病理学异常间的关系.方法收集上海市长宁区妇幼保健院2010年1月至2011年12月送检的晚孕、活产、单胎、小于胎龄儿胎盘共100例(SGA组)与紧随各SGA后送检的2例晚孕、活产、单胎、适龄儿胎盘共200例(AGA组),进行仔细的大体及镜下观察,比较其差异.结果 SGA组的孕周、新生儿出生体质量、足月新生儿出生体质量、早产率及自然分娩率均明显低于AGA组(P＜0.002).足月胎盘体积、胎盘质量及胎儿/胎盘质量比在SGA组明显小于AGA组(P＜0.05)；而脐带附着异常和脐带螺旋过多在SGA组中更多见(P＜0.05).SGA组中合体结节增多、无血管绒毛及绒毛梗死明显多于AGA组(P＜0.005)；而绒毛间血栓、慢性绒毛炎及绒毛膜血管病在两组中差异无统计学意义(P＞0.05).妊娠期高血压疾病及产前胎儿监护异常等在SGA组中较AGA组更常见(P＜0.05).结论妊娠期高血压疾病是SGA发生的主要临床因素.胎盘的某些大体观察及镜下异常可影响胎儿宫内的生长发育.
목적 탐토소우태령인(SGA)여태반병이학이상간적관계.방법 수집상해시장저구부유보건원2010년1월지2011년12월송검적만잉、활산、단태、소우태령인태반공100례(SGA조)여긴수각SGA후송검적2례만잉、활산、단태、괄령인태반공200례(AGA조),진행자세적대체급경하관찰,비교기차이.결과 SGA조적잉주、신생인출생체질량、족월신생인출생체질량、조산솔급자연분면솔균명현저우AGA조(P＜0.002).족월태반체적、태반질량급태인/태반질량비재SGA조명현소우AGA조(P＜0.05)；이제대부착이상화제대라선과다재SGA조중경다견(P＜0.05).SGA조중합체결절증다、무혈관융모급융모경사명현다우AGA조(P＜0.005)；이융모간혈전、만성융모염급융모막혈관병재량조중차이무통계학의의(P＞0.05).임신기고혈압질병급산전태인감호이상등재SGA조중교AGA조경상견(P＜0.05).결론 임신기고혈압질병시SGA발생적주요림상인소.태반적모사대체관찰급경하이상가영향태인궁내적생장발육.
Objective To investigate the relationship between pathological abnormalities of placenta and small-for-gestational-age neonates.Methods One hundred placentas of small-for-gestational-age (SGA group) and 200 appropriate-for-gestational-age (AGA group) with single living birth in third trimester were investigated by gross and microscopic examination.The AGA placentas were collected from 2 cases following every SGA placenta.All cases were collected from Shanghai Changning District Maternity and Infant Health Hospital from January 2010 to December 2011.Results The gestational week,neonatal birth weight,fullterm neonatal birth weight,the preterm birth rate and vaginal spontaneous delivery rate were significantly lower in SGA group than that in AGA group (P ＜ 0.002).Full-term placental volume,placental weight and fetal placental weight ratio were lower in SGA group than that in AGA group (P＜0.05).Unusual insertion and torsion of umbilical cord were more common in SGA group (P＜0.05).Syncytial knots increase,avascular villi and villous infarcts were significantly higher in SGA group (P ＜0.005),but there were no significant difference between SGA group and AGA group in intervillous thrombi,chronic villitis and chorangiosis (P＞0.05).Gestational hypertension disease and abnormality of fetal monitoring were more common in SGA group (P＜0.05).Conclusions Gestational hypertension disease is the main clinical cause of SGA.Some placental abnormality can affect the growth and development of intrauterine fetus.