Fetal surgery is not associated with increased inflammatory placental pathology.
Fetal surgery is not associated with increased inflammatory placental pathology.
复制标题
胎儿手术与炎症性胎盘病理的增加无关。
DOI：
10.1002/pd.6319
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发表时间：
2023
影响因子：
3
通讯作者：
Enninga,ElizabethAnnL
中科院分区：
文献类型：
--
作者：
Cardenas,MariaC;Cheek-Norgan,EHeidi;Branda,MeganE;Norgan,AndrewP;Schenone,MauroH;Lemens,MaureenA;Chakraborty,Rana;Ruano,Rodrigo;Enninga,ElizabethAnnL
胎儿手术改善了新生儿结局;然而，尚不清楚干预是否有助于胎盘炎症病理的发展。在这里，胎儿手术和胎盘病理之间的关联examined.MethodThis病例对照研究比较了妊娠与胎儿手术（n= 22），妊娠与胎儿手术的指征，但没有进行干预（n= 13），和孕龄和胎儿数量匹配的控制（n= 36）。数据的母亲，婴儿和胎盘的结果进行了抽象。此外，免疫组织化学鉴定了一部分病例胎盘中淋巴样和髓样细胞的表达。使用Kruskal沃利斯或皮尔逊卡方检验进行比较。大多数胎儿干预是为了治疗腹股沟疝、脊柱裂或双胎输血综合征。出生前接受手术的胎儿更有可能早产（p= 0.02）。有没有增加所观察到的胎盘病理或免疫细胞浸润的胎儿手术的情况下相比controls.ConclusionThe数据表明，胎儿手术是不相关的炎症或形态病理学增加胎盘的比率。这一观察结果支持了胎儿外科领域的发展。
ObjectiveFetal surgery has improved neonatal outcomes; however, it is unknown if the intervention contributes to the developmental of inflammatory pathologies in the placenta. Here, an association between fetal surgery and placental pathology was examined.MethodThis case‐control study compared pregnancies with fetal surgery (n= 22), pregnancies with an indication for fetal surgery but without an intervention being done (n= 13), and gestational‐age and fetus‐number matched controls (n= 36). Data on maternal, infant, and placental outcomes were abstracted. Additionally, immunohistochemistry identified expression of lymphoid and myeloid cells in the placenta on a subset of cases. Comparisons were performed using Kruskal‐Wallis or Pearson's chi‐squared tests.ResultsMaternal characteristics were comparable between groups. Most fetal interventions were for diaphragmatic hernia, spina bifida, or twin‐to‐twin transfusion syndrome. Fetuses who were operated on before birth were more likely to be born preterm (p= 0.02). There was no increase in the rate of observed placental pathologies or immune cell infiltration in fetal surgery cases compared to controls.ConclusionThe data suggest that fetal surgery is not associated with increased inflammatory or morphologic pathology in the placenta. This observation supports the growing field of fetal surgery.