Do placental lesions reflect thrombophilia state in women with adverse pregnancy outcome?
Do placental lesions reflect thrombophilia state in women with adverse pregnancy outcome?
复制标题
DOI：
10.1093/humrep/15.8.1830
复制
发表时间：
2000-08-01
影响因子：
6.1
通讯作者：
Alfirevic, Z
中科院分区：
文献类型：
--
作者：
Mousa, HA;Alfirevic, Z
我们检查了因严重先兆子痫/子痫、胎盘早剥、宫内生长受限或不明原因死产入院的女性的胎盘组织学与血栓形成倾向之间的关系。所有女性在分娩后至少 10 周进行血栓形成倾向筛查（抗凝血酶 III、蛋白 C、蛋白 S、活化蛋白 C 抵抗、抗心磷脂抗体、狼疮抗凝剂、空腹血浆同型半胱氨酸以及亚甲基四氢叶酸还原酶 C677T、G20210A 凝血酶原基因和 V 因子 Leiden 的特定突变。检查胎盘组织学报告以确定胎盘中血栓性病变的频率，包括胎儿干血管血栓、胎儿血栓性血管病、胎盘梗塞、绒毛周围纤维蛋白沉积、绒毛间血栓形成和胎盘底梗塞。在 17 个月的时间里，79 名女性符合研究标准，43 名血栓形成倾向筛查异常的女性中有 30 名 (70%) 存在胎盘组织学异常，36 名血栓形成倾向筛查阴性的女性中有 28 名 (78%) 存在胎盘组织学异常。异常胎盘，当比较易栓症阳性组和易栓症阴性组时，无法确定特定的组织学模式，我们认为，患有严重妊娠并发症的妇女的易栓症状态与胎盘病理变化之间的相关性较差。
We examined the relationship between placental histology and thrombophilia status in women who were admitted with severe pre-eclampsia/eclampsia, placental abruption, intrauterine growth restriction or unexplained stillbirth. All women had thrombophilia screen at least 10 weeks after delivery (antithrombin III, protein C, protein S, activated protein C resistance, anticardiolipin antibodies, lupus anticoagulant, fasting plasma homocysteine and specific mutations to methylenetetrahydrofolate reductase C677T, G20210A prothrombin gene and factor V Leiden. Placental histology reports were examined to identify the frequency of thrombotic lesions in the placenta including fetal stem vessel thrombosis, fetal thrombotic vasculopathy, placental infarction, perivillous fibrin deposition, intervillous thrombosis and placental floor infarction, During a 17 month period, a cohort of 79 women met the study criteria. Thirty (70%) out of 43 women with abnormal thrombophilia screen had abnormal placental histology, Twenty-eight (78%) out of 36 women with negative thrombophilia screen had abnormal placentae, No specific histological pattern could be identified when thrombophilia positive and thrombophilia negative groups were compared. We propose that there is a poor correlation between thrombophilia status and pathological changes of the placenta in women with severe pregnancy complications.