Chronic peripheral separation of placenta. The significance of diffuse chorioamnionic hemosiderosis.
Chronic peripheral separation of placenta. The significance of diffuse chorioamnionic hemosiderosis.
复制标题
胎盘慢性外周分离。
DOI：
10.1093/ajcp/111.6.804
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发表时间：
1999
影响因子：
3.5
通讯作者：
D. Wilson
中科院分区：
文献类型：
--
作者：
R. Redline;D. Wilson
4年来，1,023例胎盘中有36例观察到弥漫性非胎粪相关色素，并用铁染色进行评估。13例为阴性，23例(3/1000分娩；25/1000胎盘)绒毛膜板和胎膜呈阳性(弥漫性绒毛膜含铁血黄素沉着症)。DCH患者分娩时胎龄较低，且与铁染色的程度成反比。患有DCH的胎盘更有可能出现围绝、陈旧的外周血凝块、绒毛巨噬细胞增多和绿色变色。为了评估与DCH相关的人口学、产科和围产期因素，每个DCH病例选择了2名胎龄匹配的对照组。多胎、吸烟和慢性阴道出血均显著增加，而胎儿宫内发育迟缓和羊水过少增加，但无统计学意义。DCH组妊娠期高血压和高龄孕妇显著减少，可卡因滥用少见(3例)。DCH的长期神经后遗症是在一个单独的系列胎龄匹配的极低出生体重儿中进行评估的，这些婴儿在2岁时有或没有神经损害。在DCH患者中没有发现神经损害的风险增加。
Diffuse nonmeconium-related pigment was observed in the chorioamnion of 36 of 1,023 placentas over 4 years and evaluated by iron staining. Stains were negative in 13 cases and positive in chorionic plate and membranes (diffuse chorioamnionic hemosiderosis [DCH]) in 23 cases (3/1,000 deliveries; 25/1,000 placentas). Gestational age at delivery was lower in DCH and was inversely proportional to the magnitude of iron staining. Placentas with DCH were more likely to show circumvallation, old peripheral blood clots, increased chorionic-villous macrophages, and green discoloration. To evaluate demographic, obstetric, and perinatal factors associated with DCH, 2 gestational age-matched controls were selected for each DCH case. Multiparity, smoking, and chronic vaginal bleeding all were increased significantly with DCH, while intrauterine growth retardation and oligohydramnios were increased but did not achieve statistical significance. Gestational hypertension and advanced maternal age were significantly decreased with DCH, and cocaine abuse was uncommon (3 cases). Long-term neurologic sequelae of DCH were evaluated in a separate series of gestational age-matched very-low-birth-weight infants with and without neurologic impairment at 2 years of age. No increased risk of neurologic impairment was found in patients with DCH.