發(fā)布時(shí)間：2018-06-13 00:04

  本文選題：超聲心動(dòng)圖 + 胎兒　； 參考：《中華醫(yī)學(xué)超聲雜志(電子版)》2016年08期

【摘要】：目的探討先天性心臟病胎兒胎盤(pán)病變的病理特征。方法選取2010年8月至2014年4月首都醫(yī)科大學(xué)附屬北京安貞醫(yī)院超聲心動(dòng)圖二部胎兒心臟病母胎醫(yī)學(xué)會(huì)診中心胎兒心臟病母胎醫(yī)學(xué)數(shù)據(jù)庫(kù)樣本庫(kù)中先天性心臟病胎兒20例(心臟病組,均為心臟畸形引產(chǎn)胎兒),另選取產(chǎn)前超聲及產(chǎn)后檢查均正常,但因胎膜早破、羊水過(guò)少、妊娠期糖尿病、子癇前期、胎兒窘迫、先兆臨產(chǎn)、孕婦心律失常引產(chǎn)的胎兒34例(對(duì)照組),對(duì)兩組胎兒產(chǎn)前超聲及產(chǎn)后胎盤(pán)病理檢查結(jié)果進(jìn)行分析。結(jié)果先天性心臟病組胎兒中17例為妊娠中期胎盤(pán),3例為妊娠晚期胎盤(pán);對(duì)照組34例均為妊娠晚期胎盤(pán)。產(chǎn)后胎盤(pán)病理檢查顯示:(1)心臟病組20例胎兒胎盤(pán)病變18例(18/20),以重度絨毛膜炎(77.8%,14/18)、灶狀鈣化(44.4%,8/18)和血栓形成(16.7%,3/18)為主,1例胎盤(pán)梗死,2例胎盤(pán)臍帶未見(jiàn)顯著變化。(2)心臟病組10例致死性先天性心臟病胎兒的胎盤(pán)病變重于10例非致死性心臟畸形胎兒。(3)對(duì)照組34例(34/34)胎兒均顯示胎盤(pán)病變,以輕度絨毛膜炎(61.8%,21/34)、灶狀鈣化(79.4%,27/34)、纖維素樣物沉著為主(97.1%,33/34),部分為重度絨毛膜炎(26.5%,9/34)。(4)心臟病組與對(duì)照組胎兒胎盤(pán)病理檢查結(jié)果對(duì)照顯示,心臟病組胎兒的胎盤(pán)病變程度重于對(duì)照組胎兒;兩組胎兒胎盤(pán)病變的病理特征不同,超聲表現(xiàn)亦不同。結(jié)論先天性心臟病組胎兒胎盤(pán)重度絨毛膜炎、灶狀鈣化和血栓形成影響母胎血液循環(huán)及營(yíng)養(yǎng)物質(zhì)交換,可能與先天性心臟病的發(fā)生有相關(guān)性。
[Abstract]:Objective to investigate the pathological features of fetal placental lesions in congenital heart disease. Methods from August 2010 to April 2014, echocardiography from Beijing Anzhen Hospital affiliated to Capital University of Medical Sciences was selected from the database of fetal heart disease, maternal and fetal medical consultation center, Fetal Heart Disease Medical consultation Center. 20 infants (heart disease group, All of them were induced by cardiac malformation. Prenatal ultrasound and postpartum examination were all normal, but due to premature rupture of membranes, oligohydramnios, gestational diabetes mellitus, preeclampsia, fetal distress, threatened labor, Thirty-four fetuses with arrhythmia induced labor (control group) were analyzed by prenatal ultrasound and placental pathological examination. Results in the congenital heart disease group, 17 cases were placenta in the second trimester of pregnancy, 3 cases were the placenta in the third trimester of pregnancy, and 34 cases in the control group. Postpartum placental pathological examination showed 20 cases of fetal placental lesions in the heart group (18 / 18), with severe choriositis of 77.8% 14 / 18, focal calcification of 44.44% (818) and thrombus formation 16.7% (3 / 18). (1 case with placental infarction 2 cases with placental umbilical cord had no significant change. Placental lesions in 10 fetuses with fatal congenital heart disease were more serious than those with non-fatal cardiac malformations (n = 10) 34 / 34 fetuses in the control group showed placental lesions. The results of placental pathological examination showed that placenta pathological changes were more severe in heart disease group than that in control group. The pathological examination of placenta in mild chorionitis group and control group showed that placenta lesion was more severe in heart disease group than in control group, with 27 / 34% focal calcification, 97.1% 33 / 34% cellulose deposition, and 26.5p / 34% severe chorionitis respectively. The results of placental pathological examination in heart group and control group showed that the degree of placental lesion in heart disease group was more severe than that in control group. The pathological features and sonographic findings of fetal placental lesions were different between the two groups. Conclusion severe placental chorionitis, focal calcification and thrombosis affect maternal and fetal blood circulation and nutrient exchange in congenital heart disease group, which may be related to the occurrence of congenital heart disease.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京安貞醫(yī)院超聲心動(dòng)圖二部胎兒心臟病母胎醫(yī)學(xué)研究北京市重點(diǎn)實(shí)驗(yàn)室;首都醫(yī)科大學(xué)附屬北京安貞醫(yī)院病理科;
【分類(lèi)號(hào)】：R445.1;R714.5

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