HISTOPATHOLOGICAL FINDINGS IN PLACENTAE FROM PATIENTS WITH INTRAUTERINE FETAL DEATH AND ANTIPHOSPHOLIPID ANTIBODIES
HISTOPATHOLOGICAL FINDINGS IN PLACENTAE FROM PATIENTS WITH INTRAUTERINE FETAL DEATH AND ANTIPHOSPHOLIPID ANTIBODIES
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DOI：
10.1016/0028-2243(91)90021-c
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发表时间：
1991-10-08
期刊：
影响因子：
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通讯作者：
DERKSEN, RHWM
中科院分区：
文献类型：
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作者：
OUT, HJ;KOOIJMAN, CD;DERKSEN, RHWM
抗磷脂抗体与妊娠早期流产和晚期宫内胎儿死亡有关。 研究人员对 45 名子宫内胎儿死亡妇女的 47 个胎盘（包括 16 名具有抗磷脂抗体的患者）的组织病理学进行了研究，以检测具有和不具有这些抗体的妇女的胎盘之间的潜在差异。 13名患者患有系统性红斑狼疮或狼疮样疾病，其中6名女性有抗磷脂抗体。在有抗磷脂抗体的女性胎盘中，血管合胞膜减少，纤维化主要发生在梗死区，绒毛血管不足，血栓或梗塞的发生率明显高于无抗磷脂抗体女性的胎盘。 在 16 名具有抗磷脂抗体的患者的 17 个胎盘中，只有 3 个没有表现出血栓或梗塞的迹象。 血栓形成/梗塞与血管合胞膜减少、纤维化、绒毛血管不足和合胞结增加显着相关。 这些结果很可能是由于血栓或梗塞导致的长期缺氧的结果。结论是，血栓或梗塞是抗磷脂抗体和宫内胎儿死亡患者胎盘的显着特征。 因此，怀孕期间的抗血栓治疗对这些患者来说是一种合理的方法。
Anti-phospholipid antibodies are associated with first trimester abortions and late intra-uterine fetal death. The histopathology of 47 placentae from 45 women with intra-uterine fetal death, including 16 patients with anti-phospholipid antibodies, was studied in order to detect potential differences between placentae from women with and without these antibodies. Thirteen patients had systemic lupus erythematosus or lupus-like disease, including 6 women with anti-phospholipid antibodies.In placentae from patients with anti-phospholipid antibodies, a decrease in vasculo-syncytial membranes, fibrosis mainly in infarcted areas, hypovascular villi and thrombosis or infarction was seen significantly more often than in placentae from women without these antibodies. Of 17 placentae from 16 patients with anti-phospholipid antibodies, only 3 did not demonstrate signs of thrombosis or infarction. Thrombosis/infarction was significantly associated with a decrease in vasculo-syncytial membranes, fibrosis, hypovascular villi and an increase in syncytial knots. These findings are most likely to be the result of prolonged hypoxia due to thrombosis or infarction.It is concluded that thrombosis or infarctions are prominent features in placentae from patients with anti-phospholipid antibodies and intra-uterine fetal death. Consequently, antithrombotic treatment during pregnancy forms a rational approach in these patients.