Chronic abruption-oligohydramnios sequence (CAOS) revisited: possible implication of premature rupture of membranes
Chronic abruption-oligohydramnios sequence (CAOS) revisited: possible implication of premature rupture of membranes
复制标题
回顾慢性胎早剥-羊水过少序列（CAOS）：胎膜早破的可能含义
DOI：
10.1080/14767058.2021.1929159
复制
发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Kondoh Eiji
中科院分区：
文献类型：
--
作者：
Chigusa Yoshitsugu;Mogami Haruta;Minamiguchi Sachiko;Kido Aki;Ishida Ayami;Kurata Yasuhisa;Yasuda Eriko;Kawasaki Kaoru;Horie Akihito;Yamaguchi Ken;Mandai Masaki;Kondoh Eiji
目的慢性羊水过少序列症（CAOS）的发病机制尚不清楚，影像学和病理学诊断无客观标准。我们的目的是重新考虑和澄清真正的病理CAOS整合临床，磁共振成像（MRI）和组织病理学研究结果的placenta.Material和MethodsThis是一个案例系列的CAOS患者在我院管理2010年和2020年之间。患者的临床资料，包括MRI表现和胎盘病理，进行了回顾性分析。17例（94%）发生早产，分娩时的中位孕龄为25岁。3名新生儿（17%）在两年内死亡，10名新生儿（56%）发展为慢性肺部疾病。13例行MRI检查，清晰显示宫腔内血肿及出血性羊水。病理上，所有病例均未发现胎盘后血肿，胎膜极其脆弱和粗糙。羊膜上皮脱落和坏死是一个特征性的发现，这在17例（94%）中得到证实。结论CAOS的根本原因是反复宫内出血和绒毛膜下血肿，导致羊水和DCH出血。因此，这些因素导致羊膜的坏死和弱化。因此，CAOS的真正病理被认为是胎膜早破而不是慢性妊娠。
AimThe pathogenic mechanism of chronic abruption-oligohydramnios sequence (CAOS) remains unknown, and there are no objective standards for diagnosis on imaging or using pathological evidence. We aimed to reconsider and clarify the true pathology of CAOS by integrating clinical, magnetic resonance imaging (MRI) and histopathological findings of the placenta.Material and MethodsThis is a case series of patients with CAOS managed at our hospital between 2010 and 2020. The clinical data of the patients, including MRI findings and placental pathology, were reviewed retrospectively.ResultsA total of 18 patients were eligible. Preterm birth occurred in 17 (94%) cases; the median gestational age at delivery was 25. Three neonates (17%) died within two years, and 10 neonates (56%) developed chronic lung disease. MRI was performed in 13 cases and clearly showed intrauterine hematoma and hemorrhagic amniotic fluid. Pathologically, in all cases, retroplacental hematoma was not detected, and fetal membranes were extremely fragile and ragged. Shedding and necrosis of the amniotic epithelium was a characteristic finding, which was confirmed in 17 cases (94%). Diffuse chorionic hemosiderosis (DCH) was detected in all cases.ConclusionsThe fundamental cause of CAOS is repeated intrauterine hemorrhage and subsequent subchorionic hematoma, which induces hemorrhagic amniotic fluid and DCH. Consequently, these factors result in the necrosis and weakening of the amnion. Therefore, the true pathology of CAOS is believed to be premature rupture of membranes rather than chronic abruption.
登录
查看更多内容
影响因子：
8
作者：
Ohyama, M;Itani, Y;Tanaka, Y
通讯作者：
Tanaka, Y
妊娠合并弥漫性绒毛膜羊膜含铁血黄素沉着症的产科特点及其对婴儿呼吸系统疾病的影响
影响因子：
1.6
作者：
Shiro Yoshida;A. Kikuchi;S. Sunagawa;K. Takagi;Y. Ogiso;T. Yoda;Tomohiko Nakamura
通讯作者：
Tomohiko Nakamura
影响因子：
4.8
作者：
Mogami, Haruta;Kishore, Annavarapu Hari;Word, R. Ann
通讯作者：
Word, R. Ann
胎盘慢性外周分离。
影响因子：
3.5
作者：
R. Redline;D. Wilson
通讯作者：
D. Wilson
慢性早剥-羊水过少序列。
DOI：
--
发表时间：
1998
期刊：
The Journal of reproductive medicine
影响因子：
--
作者：
J. Elliott;B. Gilpin;Strong Th;H. Finberg
通讯作者：
H. Finberg