Characterisation of deep arterio-venous anastomoses within monochorionic placentae by vascular casting
Characterisation of deep arterio-venous anastomoses within monochorionic placentae by vascular casting
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DOI：
10.1016/j.placenta.2004.04.007
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发表时间：
2005-01-01
期刊：
影响因子：
3.8
通讯作者：
Fisk, NM
中科院分区：
文献类型：
--
作者：
Wee, LY;Taylor, M;Fisk, NM
目的：描述单绒毛膜 (MC) 胎盘中动静脉吻合 (AVA) 的特征，并确定 (i) 共用子叶是否位于双胞胎的动脉和对侧双胞胎的静脉的共同终止处下方，以及 (ii) 是否可以通过绒毛膜板的目视检查检测到所有 AVA。方法：由 15 个 MC 胎盘制成血管铸型。将消化前目视怀疑的典型 AVA 数量与酸消化后鉴定的 AVA 数量进行比较。结果：67 个疑似典型 AVA 中的 33 个 (49%) 在铸造后被确认为典型。有五个误报，没有误报。其余的被归类为非典型 AVA，存在于 90% 的 MC 胎盘中。在 53% 和 73% 的胎盘中分别发现了 I 型（铸模前未见的两个表面正常子叶之间的小血管连接）和 II 型（在较大的表面正常子叶内出现的共享子叶）非典型 AVA。 结论：MC 胎盘中只有一半的共享子叶具有绒毛膜板上动脉和静脉共同终止的特征。我们报告绒毛膜板下方存在深层吻合，无法通过绒毛膜板检查看到。这些发现对激光治疗双胎输血综合征具有重要意义。 (C) 2004 Elsevier Ltd. 保留所有权利。
Objective: To characterise arterio-venous anastomoses (AVA) in monochorionic (MC) placentae and determine (i) whether shared cotyledons lie beneath the co-termination of an artery from one twin and a vein to the contralateral twin and (ii) whether all AVA can be detected by visual inspection of the chorionic plate.Methods: Vascular casts were made of 15 MC placentae. The number of typical AVAs suspected visually before digestion was compared with the number of AVAs identified after acid digestion.Results: Thirty-three of 67 (49%) suspected typical AVAs were confirmed as typical after casting. There were five false positives and no false negatives. The remainder were classified as atypical AVAs, found in 90% of MC placentae. Type I (small vascular connections between two apparently normal cotyledons not seen before casting) and Type II (shared cotyledons arising within larger apparently normal cotyledons) atypical AVAs were found in 53% and 73% of placentae, respectively.Conclusions: Only half the shared cotyledons in MC placentae are characterised by co-termination of an artery and vein on the chorionic plate. We report the existence of deep anastomoses beneath the chorionic plate that cannot be visualised by chorionic plate inspection. These findings have implications for laser treatment of twin-twin transfusion syndrome. (C) 2004 Elsevier Ltd. All rights reserved.