1 769例胎盘病理检查及临床分析
| 作者: |
1陈芳芳,
1李卫东,
1张艳丽
1 深圳市宝安区妇幼保健院病理科，深圳 518133 |
| 通讯: |
李卫东
Email: 460986670@qq.com |
| DOI: | 10.3978/j.issn.2095-6959.2015.01.019 |
摘要
目的：探讨急性绒毛膜羊膜炎的发生对妊娠结局的影响。方法：对我院2013年7月~2014年7月高危 妊娠1 769例进行回顾性分析，将急性绒毛膜羊膜炎设为研究组，无炎症者为对照组，比较两组难 免流产(inevitable abortion，IA)、胎膜早破(preterm premature rupture of membranes，PPROM)、早 产(premature birth，PB)、胎儿窘迫(foetal distress，FD)、新生儿窒息(neonatal asphyxia，NA)等妊 娠结局。结果：1 769例胎盘中872例为不同程度的急性绒毛膜羊膜炎，研究组中IA 185例(21.21%)， PPROM 534例(61.24%)，PB 232例(26.62%)，对照组中IA 18例(2.01%)，PPROM 467例(52.26%)，PB 65例(7.25%)，研究组较对照组明显增高，差异有显著性(P=0.0000)，研究组中FD 96例，NA 45例， 妊娠期糖尿病(gestational diabetes mellitus，GDM) 48例，对照组FD 64例，NA 35例，GDM 32例， 两组比较差异无显著性(P>0.05)。研究组中生育医保175例，对照组生育医保237例，差异有显著 性(P=0.0016)。结论：在高危妊娠中急性绒毛膜羊膜炎能引发更高的围产期并发症，孕产妇的经 济状况及医疗条件与其有一定的相关性。
关键词：
高危妊娠
急性绒毛膜羊膜炎
妊娠期糖尿病
医保
Clinical pathological analysis of 1 769 cases of placenta
CorrespondingAuthor: LI Weidong Email: 460986670@qq.com
DOI: 10.3978/j.issn.2095-6959.2015.01.019
Abstract
Objective: Acute chorioamnionitis can cause severe complications for the infant, the aim of this study was to compare the incidence of adverse pregnancy outcome in groups of women with and without this condition during pregnancy. Methods: In this single centre study, 1 769 placental tissue samples, collected between July 2013~July 2014, from women classified as having high risk pregnancy were divided into study (n=872) and control (n=897) groups based on pathological diagnosis of acute chorioamnionitis. Adverse pregnancy outcomes, including inevitable abortion (IA), preterm premature rupture of membranes (PPROM), premature birth (PB), foetal distress (FD), neonatal asphyxia (NA) and gestational diabetes mellitus (GDM) were examined. Results: The incidence of IA, PPROM and PB was 185 (21.21%), 534 (61.24%) and 232 (26.62%) in the study group (n=872/1 769, 49.30%), and 18 (2.01%), 467 (52.26%) and 65 (7.25%) in the control group (n=897/1 769, 50.70%), respectively. There was a significant increase of these adverse pregnancy outcomes in the study group (P=0.000). The incidence of FD, NA and GDM was 96 (11.00%), 45 (5.16%) and 48 (5.50%) in the study group and 64 (7.13%), 35 (3.90%), 32 (3.57%) in the control group, respectively. These were not statistically significant different between the 2 groups (P>0.05). An interesting observation was that in the study group only 175 (20.07%) cases were covered by health insurance, whereas a significantly higher number (237, 26.42%) of cases in the control group were insured (P=0.0016). Conclusion: In this single centre study we concluded that amongst women with high risk pregnancies, acute chorioamnionitis may cause high incidence of perinatal conditions and adverse pregnancy outcomes. The observation of disparity in health insurance between the 2 groups also implies that the healthcare conditions as well as social and financial situations of the women may have also contributed to the incidence of acute chorioamnionitis and its adverse effects.