Placental causes of fetal malformation.
Placental causes of fetal malformation.
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胎儿畸形的胎盘原因。
DOI：
10.1097/00003081-199609000-00008
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发表时间：
1996
影响因子：
1.5
通讯作者：
Ward,K
中科院分区：
文献类型：
--
作者：
Craven,C;Ward,K
在贝尼尔施克博士的整个职业生涯中，他向我们讲述了胎盘发育异常与胎儿发育异常之间的关系。最近的发现强调了胎儿和胎盘之间重要的发育相互关系。我们知道，单绒毛膜双胞胎的死亡可能会导致幸存双胞胎出现异常，而且我们了解到，多胎妊娠开始的妊娠数量比足月妊娠的数量要多。妊娠 8-9 周绒毛膜绒毛取样的经验表明，早期胎盘出血可导致胎儿畸形的特征模式。绒毛膜绒毛取样还告诉我们，2% 的胎盘显示出有限的胎盘嵌合体，这可能会影响胎儿的生长和存活。最后，越来越清楚的是，大多数发育不足的婴儿要么患有原发性畸形，要么患有胎盘后天性病变，这是其生长缺陷的原因。许多其他例子可能存在，但由于缺乏对异常婴儿出生时胎盘的协调研究而仍未被认识到。感兴趣的病理学家会看到许多胎盘，但他们通常只看到发生围产期死亡的胎儿或新生儿，而且向病理学家报告的临床信息往往不充分。相反，畸形学家检查患有畸形的婴儿，但他们很少检查胎盘是否有相关畸形。同样，胚胎学家在研究胎儿发育变化时很少考虑胎盘。产科医生和围产科医生有独特的机会将婴儿的发现与胎盘的发现联系起来，但由于缺乏关于发现的潜在意义的培训，通常只进行粗略的检查。
Throughout his career, Dr. Benirschke taught us about the relationship between abnormal placental development and abnormal fetal development. Recent discoveries have emphasized the critical developmental interrelationships between fetus and placenta. We know that the demise of a monochorionic twin can lead to anomalies in the surviving twin, and we are learning that many more pregnancies begin as multiple gestations than ever reach term. Experience with chorionic villous sampling at 8-9 weeks of gestation suggests that an early placental hemorrhage can lead to a characteristic pattern of malformations in the fetus. Chorionic villous sampling also has taught us that 2% of placentas show confined placental mosaicism that can affect fetal growth and survival. Finally, it is becoming clear that most undergrown babies have either primary malformations or acquired lesions of the placenta as the cause of their growth deficiency.Many other examples probably exists but remain unrecognized because of a lack of coordinated studies of the placenta when an anomalous infant is born. Interested pathologists see many placentas, but they usually only see the fetus or newborn if a perinatal death occurs, and too frequently, insufficient clinical information is reported to the pathologist. Conversely, dysmorphologists examine babies with a malformation but they rarely examine the placenta for associated malformations. Likewise, embryologists rarely consider the placenta when studying variations in fetal development. Obstetricians and perinatologist have a unique opportunity to associate findings in the baby with those in the placenta, but too often only a cursory examination is performed because of lack of training regarding the potential significance of findings.