胎儿宫内生长迟缓患者脐动脉波形异常与胎盘病理改变的关系

目的　探讨胎儿宫内生长迟缓（IUGR）患者胎儿脐动脉波形异常与胎盘重量、体积及各级绒毛血管数量的关系。方法　选择分娩前1周内，患IUGR或B超检查有胎儿脐动脉波形异常的患者40例，分为脐动脉波形异常伴IUGR10例为研究组；脐动脉波形异常不伴IUGR（AN）；脐动脉波形正常伴IUGR（NA），脐动脉波形正常不伴IUGR（NN）各10例为对照组。用免疫组织化学SP法，检测以上各组胎盘干血管中α-平滑肌肌动蛋白（α-smoothmuscleactin，α-SMA）表达，以确定各级绒毛和各级血管，比较研究组和各对照组间胎盘重量、体积大小、各级绒毛及血管数量。结果　（1）研究组胎盘重量、体积分别为（283.40±23.82)g及（234.60±52.08)cm

Relationship of abnormal umbilical artery flow velocity waveforms and placental pathology

OBJECTIVE: To investigate the relationship of abnormal umbilical artery (UmA) flow velocity waveforms (FVWS) with placental weight, volume and all classes of villi and vessels. METHODS: Ten IUGR with abnormal umbilical artery(AA) were set as pathological group. Ten normal weight births with abnormal UmA FVWS(AN), 10 IUGR with normal UmA FVWS (NA), 10 normal weight births with normal UmA FVWS (NN) were selected as controls. Anti-alpha-SMA antibody was used to examine placental stem vessels and stem villi. The placental weight, volume, numbers of all classes of villi and vessels were compared. RESULTS: (1) Placental weight and volume in pathological group reduced significantly, while compared with AN (P < 0.01, P < 0.05, respectively), NA (P < 0.01, P < 0.001, respectively), and NN (all the P values < 0.001). (2) When the pathological group was compared with other 3 control groups with respect to the numbers of all classes of villi and vessels in placenta, the number of stem vessels reduced significantly (P < 0.05, P < 0.01, P < 0.001 respectively). The number of stem villi reduced significantly, compared with NA and NN (P < 0.01, P < 0.001, respectively). The number of stem villi did not change when compared with AN (P > 0.05). CONCLUSION: Abnormal UmA FVWS is related with placental weight, volume, all classes of villi and vessels. The reduction of villous and vascular number may be due to arrest of placental angiogenesis but not selective obliteration of vessels.