早产胎膜早破胎盘病理改变与妊娠结局的关系.docVIP

早产胎膜早破胎盘病理改变与妊娠结局的关系 　　[摘要] 目的 分析早产胎膜早破者胎盘病理改变的情况，探讨其与妊娠结局之间的关系。方法 从2013年10月―2015年9月在该院分娩的早产孕妇中方便简单选取158例早产胎膜早破者作为观察组，选取同期早产即无胎膜早破者又无合并症者作为对照组（206）例，胎盘采用统一HE染色，研究两组孕妇胎盘病理改变与妊娠结局之间的关系。结果 观察组中绒毛膜羊膜炎、合体结节增多、脐血管炎、胎盘梗死、绒毛间质纤维化其比例分别为51.9%、41.2%、15.2%、17.7%、22.8%（明显高于对照组，差异均具有统计学意义（P0.05）；观察组中胎儿窘迫、新生儿感染、产褥感染、围产儿死亡等妊娠结局的发生比例分别占13.9%、8.86%、6.33%、8.22%，明显高于对照组，差异具有统计学意义（P0.05）。结论早产胎膜早破者胎盘病理形态学改变与妊娠结局紧密相关，监测胎盘病理改变，可防治不良妊娠结局。 　　[关键词] 胎盘病理；早产胎膜早破；妊娠结局 　　[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2016）10（c）-0035-03 　　[Abstract] Objective To analysis placenta pathologic change in preterm premature rupture of membrane（PPROM），and investigate the relationship between this change and pregnancy outcomes. Methods Convenient selection retrospective investigations and analysis were carried out in 158 PPPROM who were delivered in our hospital， and 206 gestational women who were spontaneous preterm birth （no complications） were picked as control group. Placenta pathologic were finished mainly by HE dyeing. Results The infection in placenta and fetal membrane 、increases in interstitial blood vessel and syncytium nodules、deposition of fibrosis protein、calcification of placenta in observation group（51.9%，41.2%，15.2%，17.7%，22.8%） were significantly higher than control group. Patients with PPPROM had higher rates of fetal distress、infection in newborn and puerperal infection（13.9%、8.86%、6.33%、8.22% in observation group），the difference was statistically significant（P0.05）. There was no significant difference on placenta tumor and asphyxia. Conclusion Pregnancy outcomes were closely related with placenta pathologic change. Testing this change may be a necessary measure to prevent and treat the adverse outcomes. 　　[Key words] Placenta pathologic ；Preterm premature rupture of membrane ；Pregnancy outcomes 　　早产胎膜早破是指发生在妊娠满28至不满37周（196～258 d），临产前胎膜自发性破裂（preterm premature rupture of membranes，PPROM）。我国发生率为2.0%～3.5%，早产儿各器官发育尚不成熟，围产儿发病率和病死率相当高[1]。胎膜早破是导致早产的主要原因[2]。胎盘介于胎儿和母体之间，是母胎生理交换的重要场所，胎盘和脐带结构和功能异