过期与延期妊娠胎盘形态学变化及其与妊娠结局的关系

目的 探讨过期、延期妊娠胎盘绒毛和胎盘床螺旋动脉的病变特点及其与胎儿预后的关系。方法 应用图像分析技术对过期妊娠２０例（过期组）、延期妊娠１５例（延期组）和正常足月妊娠２９例（对照组）,进行形态计量学观察。结果 过期组的胎盘重量减轻,绒毛合体细胞结节增多,细胞滋养细胞增生,基底膜增厚,纤维素样坏死,血管合体细胞膜形成,绒毛直径、周长、面积,胎盘床螺旋动脉管壁增厚,以及羊水过少和羊水粪染的发生率均与

Placental morphometriological study on prolonged and delayed pregnancy and its relationship to pregnancy outcome

OBJECTIVE: To study the morphological characteristics of the placental villous vessels and uteroplacental spiral arteries in the prolonged and delayed pregnancy and its relationship to pregnancy outcome. METHODS: Placentae from 20 cases of prolonged pregnancy (PP), 15 cases of delayed pregnancy (DP), and 29 cases of normal term pregnancy (NTP) were examined by morphometriological feature image analysis. RESULTS: Significant differences were found between PP and NTP groups (P < 0.05) in the following findings: the placental weights, the numbers of the placental villus with the syncytial knots, cytotrophoblasts, thickening of basal lamina, fibrinoid necrosis, vasculosyncytial membranes, and the diameter, perimeter and area of the villi the spiral artery wall thickening of the uteroplacental bed, and the incidences of the oligoamnios and amniotic fluid meconium staining. Significant differences of the villus perimeter and oligoamnios were only found between DP and NTP (all P < 0.05). There was no significant differences in the indices between PP and DP. As the pregnancy delayed and prolonged, the placental weights gradually decreased and the low Apgar score of neonates gradually increased. CONCLUSION: After term pregnancy the placental function is gradually lowered especially in PP. The situations of the placenta, amniotic fluid, and fetus should be frequently monitored after 40 gestational weeks.