胎盘巨大绒毛血管瘤致胎儿死亡1例

1　病例摘要孕妇3 5岁,G1 P0 ,孕2 7周。常规作B超检查,超声所见:胎儿头位于脐上,双顶径7.1 cm ,胎心规则,胎动正常,胎儿脊柱、四肢、肝、肾等均未见异常。胎盘位于宫底后壁,厚6 cm,成熟度 级,于胎儿面见一低回声与强回声交织成网状的团块,大小8.3 cm×5 .9cm×7.5 cm边界清晰,与胎盘紧密相连;羊水最大深度6 .0 cm。超声诊断:宫内单胎妊娠活胎,L SA;胎盘绒毛血管瘤。门诊医生按常规给予处理,并口头交代注意事项。此孕妇在妊娠3 4 +2 周时,自觉无胎动而就诊,超声所见:胎儿头位于脐上,头皮水肿呈双环征,未见胎动及胎心搏动,胎盘所见同上。…     

妊娠肝内胆汁瘀积症胎盘病理改变与胎儿窘迫的探讨

目的：探讨妊娠肝内胆汁瘀积症(ICP)胎盘病理改变与胎儿宫内缺氧的关系。方法：对ICP患治疗组、未治疗组各12例及正常妊娠孕妇12例胎盘组织进行病理学观察。结果：ICP胎盘组织病理观察可见绒毛水肿，绒毛间隙狭窄，合体细胞结节增多，血管合体膜增厚；正常组、治疗组上述病理改变发生率减少或减轻。结论：ICP患血胆汁酸升高，绒毛间隙狭窄是引起ICP的主要病理基础；中西医结合治疗及密切监护，可降低围产儿病死率。     

中度高原(西宁)与平原(南京)足月胎盘绒毛的体视学研究

目的探讨高原低氧对足月胎盘绒毛的影响。方法用体视学方法计算中度高原与平原地区(分别以西宁和南京为例)足月胎盘绒毛的数密度(Nv)、体密度(Vv)、表面积密度(Sv)、平均自由呈(λ)。结果两地各项指标均有显著性差异。结论提示高原气候对胎儿孕至足月期间的胎盘无显著影响。     

胎儿宫儿窘迫的胎盘组织计量学研究

<正> 为了进一步探讨胎儿宫内窘迫(以下缩写为FD)的胎盘组织病理学方面的变化,我们对8例胎盘进行组织计量学研究。材料与方法一、一般资料:选8例无脐带异常的胎儿窘迫的胎盘.并选择母亲的年龄、身高、体重、妊周、胎次、分娩方式、产程以及新生儿体重等相似的同期分娩的正常孕妇8例胎盘做为配对。16例孕妇年龄分布在23～32岁,平均26.8岁,妊周为37～42周。均为头位分娩的初产妇,亦无其它并发症。     

彩色超声多普勒测定脑-胎盘比值对胎儿窘迫的诊断价值

目的探讨彩色超声多普勒测定脑-胎盘比值对胎儿窘迫的诊断价值。方法从2014年2月至2015年2月我院产科收治的孕妇中选取80例产妇,其中40例为发生胎儿窘迫孕妇,40例为胎儿正常孕妇,胎儿窘迫孕妇命名为观察组,胎儿正常孕妇命名为对照组,对80例产妇应用彩色超声多普勒测定两组胎儿大脑中动脉(MCA)、脐动脉(UA)的血流动力学指标,计算并比较两组胎儿脑-胎比值(CPR)。结果观察组胎儿的MCA的PI、RI和S/D、和胎儿CPR比值均低于对照组,差异具有统计学意义(P<0.05);观察组胎儿的UA的PI、RI和S/D比值均高于对照组,差异具有统计学意义(P<0.05)。结论彩色超声多普勒测定脑-胎盘比值能够较好的反应胎儿宫内情况,是预测和诊断胎儿窘迫的重要指标。     

不明原因胎儿宫内发育迟缓胎盘床和胎盘血管病变的探讨

对２０例不明原因胎儿宫内发育迟缓孕妇（ＩＵＧＲ组）和２９例正常妊娠孕妇（对照组）的子宫胎盘床螺旋动脉和胎盘绒毛血管病变进行观察，应用免疫组经技术进行ＩｇＡ、ＩｇＧ、ＩＭ和Ｃ３检测，探讨ＩＵＧＲ的发生及其临床病理学意义。结果：（１）ＩＵＧＲ组胎盘床螺旋动脉妊娠生理性改变缺乏、管壁增厚、纤维素样坏死和动脉急性粥样化的发生率（分别为６０％、５０％、４０％和４０％）显著高于对照组（分别为６．９％、６．９％     

胎儿窘迫与新生儿窒息的关系

目的：探讨胎儿窘迫与新生儿窒息的关系及其发生原因，寻找新生儿窒息的预防措施。方法：对2002年1月-2006年10月在我院分娩围生儿进行回顾性分析．对其中出现胎儿窘迫和新生儿窒息者及其发生原因进行分析。结果：（1）胎心率与羊水均异常的新生儿窒息率可达41．66％，重度窒息占14．58％；（2）胎心率改变程度与新生儿窒息密切相关，小于80次，分窒息明显；（3）胎儿窘迫致新生儿窒息的原因中。脐带因素占首位，妊娠合并ICGR、产前出血重度窒息率增高。结论：胎儿窘迫是新生儿窒息的先兆，通过对胎心率及羊水性状综合分析，及妊娠并发症的防治，可以对新生儿窒息发生的可能性预先评估，加强救治及减少发生。     

胎儿窘迫与新生儿窒息发生关系的分析

对９１２例胎儿窘迫和２４８例新生儿窒息进行回顾性分析，结果显示：伴胎儿窘迫的新生儿窒息占新生儿窒息总数的８７．５％，明显高于不伴有胎儿窘迫的新生儿窒息率。胎儿窘迫和新生儿窒息的发生率与低出生体重与早产有明显的关系，在宫内五项监护中，出现异常监护的指标越多，胎窘和新生儿窒息的发生率越高。     

胎儿窘迫与新生儿窒息关系的研究

目的探讨胎儿窘迫与新生儿窒息的关系。方法对2053例产妇中因胎心率异常、羊水污染及胎儿电子监护诊断的胎儿窘迫及出生后Apgar评分进行分析。结果(1)胎心率与羊水均异常者新生儿窒息率可达40.32%;重度窒息率达11.29%;(2)胎心率减慢程度与新生儿窒息率密切相关,胎心率低于60次/min,新生儿重度窒息率达61.54%;(3)胎儿窘迫持续时间与新生儿窒息率呈正相关,胎儿窘迫超过60min,新生儿窒息率可达88.33%,与胎儿窘迫少于30min者相比,差异非常显著(P<0.01)。结论胎儿窘迫是新生儿窒息的先兆,通过对胎心率及羊水性状综合分析,可以对新生儿窒息发生的可能性做出预先判断,以便提早防范。     

胎儿窘迫与新生儿窒息的关系

目的 探讨胎儿窘迫与新生儿窒息的关系，寻找新生儿窒息的预防措施。方法 对100例新生儿窒息的原因进行分析。结果 脐带因素。羊水过少的主要原因。分别占36%，23%；重度窒息中早产，过期妊娠，ABO血型不合居前三位。结论 做好产前保健，防治有关合并症，产时对具有窒息高危因素的孕妇作胎儿重点监护。及时防治胎儿窘迫。     

巨大胎儿与相关内分泌因素探讨

目的　探讨巨大胎儿与相应内分泌之间的关系。方法　采用酶联免疫吸附法 (ELISA)测定 62例巨大胎儿的垂体泌乳素、雌激素、孕激素及空腹血糖水平 ,并与同期对照组 60例进行比较。结果　巨大胎儿组垂体泌乳素为 ( 15 6.7± 3 7.5 )ng ml ,对照组 ( 114 .6± 43 .4)ng ml ,差异非常显著 ( P <0 .0 1) ;雌激素为 ( 5 10 .7± 161.8)pg ml ,对照组 ( 3 99.0± 10 6.6)pg ml ,差异亦有显著性 (P <0 .0 1)。孕激素巨大儿组为 ( 4 .6± 5 .0 )ng ml,对照组为 ( 2 .2± 0 .4)ng ml ,差异亦有显著性 (P <0 .0 1) ;空腹血糖为( 3 .7± 0 .5 8)mmol L ,对照组为 ( 2 .9± 1.1)mmol L ,差异非常显著 (P <0 .0 1)。结论　巨大胎儿的发生可能与高水平催乳素和高水平雌激素有关 ,通过发挥胎盘催乳素及蜕膜催乳素作用而增加血管内皮生长因子的表达和胰岛素样生长因子的表达及增加胎盘 子宫血流量 ,引起胎儿过度发育而成为巨大儿     

胎儿窘迫的诊断指标及相关因素分析

目的:探讨胎儿窘迫的诊断指标及相关因素。方法:分析233例以胎儿窘迫为指征行剖宫产病儿,按胎儿窘迫的不同诊断指标进行分组比较,统计其新生儿窒息率、胎儿窘迫相关因素百分率。结果:(1)随着胎儿窘迫诊断指标项目的增多,检出的新生儿窒息率和胎儿窘迫相关因素百分率也相应升高。(2)胎儿窘迫的主要相关因素为脐带因素、羊水过少、胎盘因素等。结论:(1)胎儿窘迫应采取多指标诊断。(2)对于有胎儿窘迫相关因素者,应密切监护、积极处理、适时行剖宫产术。     

电子胎心监护诊断胎儿窘迫的临床研究

目的 探讨电子胎心监护诊断胎儿窘迫的临床价值.方法 选取2010年1月～2011年12月于本院住院分娩的178例孕产妇电子胎心监测图形,进行回顾性分析.结果 观察产妇电子胎心监护图形,其中106例为正常组,72例为异常组,正常组的自然分娩率为83.96％,明显高于异常组(40.28％),两组比较,差异有统计学意义(P＜0.05);正常组胎儿脐带异常发生率为12.26％,且未出现新生儿窒息,与异常组比较,差异有统计学意义(P＜0.05).结论 产前胎心监护异常曲线对胎儿宫内窘迫症的诊断具有重要的临床应用价值.     

The influence of cholinergic blockade on the uptake of alpha-aminoisobutyric acid by isolated human placental villi

Isolated villus from human term placenta contains about 167 nmol of acetylcholine (ACh) per gram of wet tissue and releases about 35 pmol of ACh/g/min when it is suspended in Krebs-Ringer bicarbonate buffer at 37°C. Chronic doses of nicotine, or smoking, which modify ACh output from human placental villus, are known to retard fetal intrauterine growth. Since one of the functions of placental villi is nutrient transport, and since it has not been possible to obtain ACh-free villi, the effects of cholinergic blockade by high concentrations of ACh (2 × 10^?3m), phospholine (5 × 10^?4m), nicotine (2.5 × 10^?3m), and atropine (10^?4 to 5 × 10^?4m) on active uptake of α-aminoisobutyric acid (AIB) were studied to explain their antigrowth effects. High concentrations of ACh and nicotine decreased the rate of uptake of AIB by 34 and 41%, respectively. Atropine inhibited the AIB uptake by 29 and 61% at concentrations of 10^?4 and 5 × 10^?4m, respectively. If all Ach were released from the syncytiotrophoblast, the concentration of ACh in the medium would be about 1.67 × 10^?5m. At the highest concentration of atropine used, the concentration of the active antagonist, d(?)S-hyoscyamine, in the medium is 2.5 × 10^?4m, which depressed AIB uptake by about 61%. Phospholine (an irreversible cholinesterase inhibitor) at 7 × 10^?6m increased AIB uptake by 20%, but it decreased AIB uptake at higher concentrations, with or without exogenous ACh. Mecamylamine (10^?4m) and d-tubocurarine (10^?4m) did not influence the AIB uptake. Among the pharmacological agents studied, nicotine increased the release of endogenous placental ACh, while atropine decreased ACh release. These observations indicate that endogenously released ACh exhibits a muscarinic effect on the placental villus and facilitates the uptake of amino acids. Blockade of the facilitating effects of ACh on amino acid uptake by placenta for long periods during pregnancy may result in a retardation of fetal growth.     

Relationship between fetal weight, placental growth and litter size in mice from mid- to late-gestation

In mammals, the placenta, which consists of maternal and fetal components, is important in fetal development because it supplies the fetus with the nourishment it needs. We investigated the effects of placental growth and litter size on mouse fetal weights from mid- to late-gestation. The mean weight of male fetuses at 13.5 days post coitum (dpc) was larger than that of females. Although there was a significant correlation between fetal and placental weights in both males and females during mid-gestation (P<0.05), there was no correlation during late-gestation. However, a significant correlation was observed between litter size and fetal weights in both males and females at 17.5 dpc (P<0.05). These findings suggest that fetal weight is regulated by placental growth during mid-gestation, while the effects of litter size are more prominent towards late-gestation.     

Maternal cadmium,placental PCDHAC1, and fetal development

Cadmium (Cd) is a ubiquitous environmental contaminant implicated as a developmental toxicant, yet the underlying mechanisms that confer this toxicity are unknown. Mother-infant pairs from a Rhode Island birth cohort were investigated for the potential effects of maternal Cd exposure on fetal growth, and the possible role of the PCDHAC1 gene on this association. Mothers with higher toenail Cd concentrations were at increased odds of giving birth to an infant that was small for gestational age or with a decreased head circumference. These associations were strongest amongst those with low levels of DNA methylation in the promoter region of placental PCDHAC1. Further, we found placental PCDHAC1 expression to be inversely associated with maternal Cd, and PCDHAC1 expression positively associated with fetal growth. Our findings suggest that maternal Cd affects fetal growth even at very low concentrations, and some of these effects may be due to the differential expression of PCDHAC1.     

血管内皮细胞生长因子与大肠癌浸润转移关系的研究

目的 探讨血管内皮细胞生长因子（Vascular Endothelial Growth Factor,VEGF)与大肠癌浸润及转移的关系。方法 应用免疫组织化学法,检测78例大肠癌VEGF的表达,分析VEGF与大肠癌浸润及转移的关系。结果 有淋巴结转移者VEGF表达阳性率为62．5％（20／32）,明显高于无淋巴结转移者26．0％（12／46）,P＜0．01）;有肝转移者VEGF表达阳性率为73．3％（11／15）,明显高于无肝转移者33．3％（21／63）,P＜0．01）。另外,VEGF还与大肠癌浸润深度有关P＜0．001）。结论 VEGF与大肠癌浸润、转移有明显正相关关系;VEGF可作为预测大肠癌病期发展及转移的指标之一。