Placental surface shape, function, and effects of maternal and fetal vascular pathology.
Placental surface shape, function, and effects of maternal and fetal vascular pathology.
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DOI：
10.1016/j.placenta.2010.09.005
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发表时间：
2010-11
期刊：
影响因子：
3.8
通讯作者：
Thorp, J.
中科院分区：
文献类型：
--
作者：
Salafia, C. M.;Yampolsky, M.;Misra, D. P.;Shlakhter, O.;Haas, D.;Eucker, B.;Thorp, J.
在临床实践中，胎盘表面形状的变化是常见的。我们测量出生队列中的平均胎盘形状和偏离平均值对胎盘功能效率的影响。我们测试胎盘形状改变是否提高了临床结果中母体子宫胎盘和胎儿胎盘血管病理组织病理学诊断的特异性。来自前瞻性队列的1225个胎盘有绒毛膜板数码照片，每隔1-2厘米标记周长。在排除早产（n=202）和膜样脐带插入（n=44）后，分析了979例（95.7%）胎盘。估计中位形状和平均周长。胎儿体重与胎盘体重的关系作为胎盘效率的指标，称为“β”。母体子宫、胎盘和胎儿胎盘血管病变的主要胎盘组织病理学诊断是通过对个体病变评分的回顾来编码的。急性胎儿炎症被评分为“阴性对照”病理，预计不会影响形状。亚组比较采用Bonferroni检验的方差分析。足月平均胎盘绒毛膜形状为圆形，半径约9.1 cm。胎盘形状变异性的增加与胎盘功能效率的降低有关。在对胎盘形状进行分层后，只有当形状异常时，母体子宫胎盘或胎儿胎盘血管病变的存在才与胎盘效率降低显著相关。量化胎盘形态异常是一种有意义的临床手段。异常形状与胎盘效率降低有关。我们假设这种形状反映了胎盘血管结构的变形，并且异常的胎盘形状作为母体子宫胎盘和/或胎儿胎盘血管病理的标志，足以长期影响胎盘（进而可能影响胎儿）的发育。
In clinical practice, variability of placental surface shape is common. We measure the average placental shape in a birth cohort and the effect deviations from the average have on placental functional efficiency. We test whether altered placental shape improves the specificity of histopathology diagnoses of maternal uteroplacental and feto-placental vascular pathology for clinical outcomes. 1225 placentas from a prospective cohort had chorionic plate digital photographs with perimeters marked at 1–2 cm intervals. After exclusions of preterm (n=202) and velamentous cord insertion (n=44), 979 (95.7%) placentas were analyzed. Median shape and mean perimeter were estimated. The relationship of fetal and placental weight was used as an index of placental efficiency termed “β”. The principal placental histopathology diagnoses of maternal uteroplacental and fetoplacental vascular pathologies were coded by review of individual lesion scores. Acute fetal inflammation was scored as a“negative control” pathology not expected to affect shape. ANOVA with Bonferroni tests for subgroup comparisons were used. The mean placental chorionic shape at term was round with a radius estimated at 9.1 cm. Increased variability of the placental shape was associated with lower placental functional efficiency. After stratifying on placental shape, the presence of either maternal uteroplacental or fetoplacental vascular pathology was significantly associated with lower placental efficiency only when shape was abnormal. Quantifying abnormality of placental shape is a meaningful clinical tool. Abnormal shapes are associated with reduced placental efficiency. We hypothesize that such shapes reflect deformations of placental vascular architecture, and that an abnormal placental shape serves as a marker of maternal uteroplacental and/or fetoplacental vascular pathology of sufficiently long standing to impact placental (and by extension, potentially fetal) development.
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影响因子：
3.8
作者：
Yampolsky, M.;Salafia, Carolyn M.;Shlakhter, O.;Haas, D.;Eucker, B.;Thorp, J.
通讯作者：
Thorp, J.
影响因子：
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影响因子：
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通讯作者：
Waters, BL
影响因子：
3.8
作者：
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通讯作者：
Yampolsky M
影响因子：
3.8
作者：
Yampolsky, M.;Salafia, C. M.;Shlakhter, O.;Haas, D.;Eucker, B.;Thorp, J.
通讯作者：
Thorp, J.