胎盘绒毛膜血管瘤的临床病理分析

目的:探讨妊娠合并胎盘绒毛膜血管瘤的产前并发症、临床病理联系和围生期结局。方法:回顾性分析2002年1月～2008年12月广州市妇婴医院诊断的24例胎盘绒毛膜血管瘤患者的病历资料,通过复阅病历和病理切片,获得胎盘绒毛膜血管瘤的临床表现、产前超声图像、临床病理特点和围生期结局。结果:24例胎盘绒毛膜血管瘤中,7例产前彩色多普勒明确诊断,直径均大于4 cm。其中23例单胎妊娠,1例双胎妊娠。23例单胎中,14例有以下并发症:重度子痫前期3例、羊水过少3例、羊水过多4例、胎儿窘迫3例、胎儿生长受限3例、早产儿10例、新生儿窒息3例、新生儿黄疸2例、新生儿死亡2例。1例双胎妊娠伴有胎儿生长受限和双胎输血综合征。无胎儿水肿、心衰和胎儿畸形。结论:胎盘绒毛膜血管瘤与妊娠并发症发生有关,最常见的是早产、羊水异常和胎儿生长受限。建议密切随访,包括对产前诊断时无相关并发症的病例。

Clinical pathologic analysis of placental chorioangioma

Objective:To explore the prenatal complications,clinical pathological characteristics and perinatal outcomes of placental chorioangioma during pregnancy.Methods:Clinical data of 24 patients with placental chorioangioma during pregnancy diagnosed in the hospital from January 2002 to December 2008 were analysed retrospectively,then clinical manifestations,prenatal ultrasonography,clinical pathological characteristics and perinatal outcomes were obtained.Results:Among 24 patients with placental chorioangioma during pregnancy,7 patients were diagnosed by color Doppler ultrasound definitely,the diameter was larger than 4 cm.23 patients were monocyesis and 1 patient was twin pregnancy.Among 23 monocyesis,14 patients had complications: 3 patients of severe preeclampsia,3 patients of oligohydramnios,4 patients of polyhydramnios,3 patients of fetal distress,3 patients of fetal growth restriction,10 patients of preterm infants,3 patients of neonatal asphyxia,2 patients of neonatal jaundice and 2 patients of neonatal death.The twin pregnancy had fetal growth restriction and twin-twin transfusion syndrome.No fetal hydrops,heart failure or fetal abnormality was detected.Conclusion:Placental chorioangioma is related to complications of pregnancy,and the most common complications are preterm delivery,polyhydramnios,oligohydramnios and fetal growth restriction.Close follow-up is important during pregnancy,even for those cases with no abnormal findings at the time of prenatal diagnosis.