胎盘血管瘤的临床特点及病理分析

目的　探讨胎盘血管瘤的临床特点及病理大体观特征。方法　对我院收治的 12例胎盘血管瘤患者的临床资料作回顾性分析。结果　 ( 1)在 12例病理诊断为胎盘血管瘤的患者中 ,5例临床诊断为胎盘血管瘤 ;2例临床误诊为胎盘早剥血肿 ;1例误诊为脂肪瘤 ;1例误诊为胎盘囊肿 ;3例分娩后漏诊 ,直至胎盘病理检查时发现而诊断。 4例产前曾行彩色多普勒超声检查 ,2例获得诊断 ,2例漏诊。 ( 2 ) 12例患者中 ,3例发生早产 ,其中 2例并发羊水过多 ;2例并发妊娠高血压综合征 ;2例死胎 ;1例胎儿畸形。新生儿 3例苍白窒息 ,1例青紫窒息。 ( 3)胎盘病理大体观检查 ,肿瘤大小 2cm×2cm× 2cm至 11cm× 8cm× 8cm ;9例患者肿瘤为单个 ,2例患者为 2个 ;6例肿瘤颜色为暗红色 ,3例灰红色 ,1例淡黄色 ,1例部分暗红、部分灰白 ,1例部分暗红、部分淡黄。结论　 ( 1)胎盘血管瘤可引起孕妇早产、羊水过多、死胎及新生儿窒息等并发症。 ( 2 )胎盘血管瘤在产前不易诊断 ,彩色多普勒超声是产前诊断胎盘血管瘤的惟一辅助手段。 ( 3)胎盘血管瘤大体观肿瘤体积大小不一 ,颜色大多为暗红色 ;也可因夹杂不同组织或供血不足而呈黄色或灰白色

Clinical characteristics and pathologic study of placental chorioangioma

OBJECTIVE: To describe the clinical characteristics and gross picture of placental chorioangioma. METHODS: Clinicopathologic data from twelve cases of placental chorioangioma were retrospectively studied. RESULTS: (1) In twelve cases pathologically diagnosed as placental chorioangioma, five cases were consistent with the clinical diagnosis; two cases were misdiagnosed as placental abruption; one case was misdiagnosed as lipoma; one case was misdiagnosed as placental cyst; and three cases were missed. Color Doppler ultrasound examination was performed in four cases ante partum, in which two cases were diagnosed correctly and two cases were missed. (2) Premature labor occurred in three cases of chorioangioma, two of which were associated with polyhydramnios. Two were complicated with pregnancy-induced hypertension syndrome. Fetal death occurred in two cases and fetal abnormality in one case and neonatal asphyxia in four cases. (3) Placental chorioangiomas of all cases ranged from 2 cm x 2 cm x 2 cm to 11 cm x 8 cm x 8 cm in size. There was single tumor in nine cases and two tumors in three cases. The tumor appeared deep red in six cases, grayish red in three cases, pale yellow in one case, partial deep red and partial gray white in one case, partial deep red and partial pale yellow in one case. CONCLUSIONS: Placental chorioangioma can induce several complications such as premature labor, fetal death, polyhydramnios and neonatal asphyxia. Color Doppler is helpful to differential diagnosis of placental masses particularly placental chorioangioma, though the later is difficult to diagnose ante partum. Placental chorioangioma is varied in size with deep red in appearance for most of them and maybe yellow or gray white due to mixed with other tissues or lack of blood supply.