Placental pathology suggesting that preeclampsia is more than one disease
Placental pathology suggesting that preeclampsia is more than one disease
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DOI：
10.1016/j.ajog.2013.09.010
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发表时间：
2014-01-01
影响因子：
9.8
通讯作者：
Leveno, Kenneth J.
中科院分区：
文献类型：
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作者：
Nelson, David B.;Ziadie, Mandolin S.;Leveno, Kenneth J.
目的：我们的目的是评估发生在不同胎龄的子痫前期妇女的胎盘病理学。研究设计：这是一项前瞻性观察性研究的二次分析，该研究对预先确定的复杂妊娠的胎盘进行了常规的标准化检查。在这项研究中，将没有重大畸形的活产单胎妊娠的胎盘诊断数据库与计算机化的产科数据库相关联。根据子痫前期诊断时的胎龄，对包括血管（动脉粥样硬化、梗死）和非血管（增生）改变在内的标准化胎盘发现的比率进行评估。结果：2001年1月1日至2007年9月30日，我院共分娩7122例妊娠合并先兆子痫妇女。其中，1210例（17%）进行了胎盘检查。在该队列中，分别有209、355和646名妇女在妊娠24（0/67）至33（6/7）、34（0/7）至36（6/7）和37（0/7）周或更长时间被诊断为先兆子痫。胎盘检查结果显示发育不全与妊娠晚期子痫前期显著相关，胎盘血管病变组织学证据在妊娠24（0/67）至33（6/7）周（53%）显著增加，而34（0/7）至36（6/7）和37周及以上时分别为34%和26% (P
OBJECTIVE: Our purpose was to evaluate the placental pathology in women with preeclampsia occurring at varying gestational ages.STUDY DESIGN: This was a secondary analysis of a prospective observational study of placentas from prespecified complicated pregnancies routinely submitted for standardized examination. For this study, a database of placental diagnoses from liveborn singleton gestations without major malformations was linked to a computerized obstetric database. The rates of standardized placental findings including vascular (atherosis, infarction) and nonvascular (hyperplasia) changes were evaluated according to gestational age at diagnosis of preeclampsia.RESULTS: Between Jan. 1, 2001, and Sept. 30, 2007, a total of 7122 women with pregnancies complicated by preeclampsia were delivered at our hospital. Of these, 1210 (17%) had placental examinations. Within this cohort, 209, 355, and 646 women were diagnosed with preeclampsia at gestations of 24(0/67) to 33(6/7), 34(0/7) to 36(6/7), and 37(0/7) weeks or longer, respectively. Placental findings revealed hypoplasia was significantly associated with preeclampsia early in the third trimester, and histological evidence of placental vascular lesions was significantly increased at gestations of 24(0/67) to 33(6/7) weeks (53%) compared with 34% and 26% at 34(0/7) to 36(6/7) and 37 weeks or longer, respectively (P