The placenta in pre-eclampsia and intrauterine growth restriction: Studies on exchange surface areas, diffusion distances and villous membrane diffusive conductances
The placenta in pre-eclampsia and intrauterine growth restriction: Studies on exchange surface areas, diffusion distances and villous membrane diffusive conductances
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DOI：
10.1016/j.placenta.2006.02.011
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发表时间：
2007-02-01
期刊：
影响因子：
3.8
通讯作者：
Baker, P. N.
中科院分区：
文献类型：
--
作者：
Mayhew, T. M.;Manwani, R.;Baker, P. N.
我们检验零假设，胎盘绒毛膜的形态弥散电导不改变妊娠并发宫内生长受限（IUGR）或先兆子痫（PE）。胎盘收集自血压正常的IUGR、单纯PE、PE + IUGR病例和对照妊娠。对福尔马林固定、三色染色的组织切片上的显微镜视野进行随机取样，以确定位置和方向。使用体视学方法，外周（终端和中间）绒毛和胎儿毛细血管的交换表面积和绒毛膜的算术和谐波平均厚度（母体方面的滋养层管腔方面的血管内皮）进行了估计。该膜的厚度的可变性的指数，并估计其氧扩散电导，推导出次要。组间比较采用双向方差分析，以确定主要影响（PE或IUGR）和交互作用（PE和IUGR之间）。PE对胎盘形态没有显著影响，PE或IUGR对膜厚度或其变异性也没有显著影响。相反，IUGR（有或无PE）与表面积减少，这是导致这些胎盘的膜扩散电导较小的主要因素。当考虑胎儿质量时，尽管纯IUGR胎盘的质量比电导似乎小于对照组，但比电导显示PE或IUGR无影响。总电导的下降表明绒毛滋养层和胎儿血管系统水平的扰动，这些可能有助于胎儿缺氧应激。(c)2006爱思唯尔有限公司保留所有权利。
We test the null hypothesis that the morphometric diffusive conductance of the placental villous membrane does not alter in pregnancies complicated by intrauterine growth restriction (IUGR) or pre-eclampsia (PE). Placentas were collected from cases of normotensive IUGR, pure PE, PE + IUGR and from control pregnancies. Microscopical fields on formalin-fixed, trichrome-stained histological sections were randomly sampled for location and orientation. Using stereological methods, the exchange surface areas of peripheral (terminal and intermediate) villi and their fetal capillaries and the arithmetic and harmonic mean thicknesses of the villous membrane (maternal aspect of trophoblast to luminal aspect of vascular endothelium) were estimated. An index of the variability in thickness of this membrane, and an estimate of its oxygen diffusive conductance, was derived secondarily. Group comparisons were drawn using two-way analysis of variance to identify main effects (of PE or IUGR) and interaction effects (between PE and IUGR). PE did not have significant effects on placental morphology and there were no significant effects of PE or IUGR on membrane thickness or its variability. In contrast, IUGR (with or without PE) was associated with reduced surface areas and this was the principal factor leading to a smaller membrane diffusive conductance in these placentas. When account was taken of fetal mass, specific conductance showed no effects of PE or IUGR despite the mass-specific conductance in pure IUGR placentas appearing to be smaller than that in controls. The decline in total conductances is indicative of perturbations operating at the levels of villous trophoblast and fetal vasculature and these may contribute to fetal hypoxic stress. (c) 2006 Elsevier Ltd. All rights reserved.