| Purpose:To investigate the pathological changes of the placenta with II and III degree meconium stained amniotic fluid,and analysis of the relationship between placental pathological changes and pregnancy outcome.Methods:1.Collected from May 2016 to May 2017 in the first hospital of Shanxi Medical University 80 pregnant women with meconium II and III degree meconium stained amniotic fluid as an observation group(the amniotic fluid group),age 21~41 years,mean age 29.8±5.3 years old;gestational age of 36~42 weeks,the average gestational age of39.4±1.6 weeks;56 cases of spontaneous delivery and 24 cases of cesarean section.The related clinical data and placental pathological examination of 80 cases of pregnant women without amniotic fluid infection were collected as control group,age 22~37 years, average age 28.9±3.2 years.The gestational age was 32~42 weeks,the average gestational age was 39.8±1.9 weeks;64 cases were delivered smoothly,and 16 cases were cesarean section.The indication of cesarean section were uterine scar and breech.The two groups of pregnant women except for diabetes,hypertension,abnormal liver and kidney function and other diseases.The process of pregnancy were smooth and there were no umbilical cord around the neck or the wound.2.Comparisonthe the observation group and the control group of maternal age,gestational age,parity and mode of production in general,then analyze data of two groups statistically by t test.3.The pathological changes of two groups of placenta were observed under microscope.Whether chorioamnionitis,syncytial nodules increased,villous interstitial fibrosis and placental calcification were observed,then analyze data of two groups statistically byχ~2 test.4.Immunohistochemical method was used to detect the expression of HIF-1 alpha in the observation group and the control group,then analyze data of two groups statistically byχ~2 test.5.Statistics of adverse pregnancy outcomes of pregnant women in the observation group and the control group,then analyze data of two groups statistically byχ~2 test.Results:1.Compared the observation group pregnant women in the age,gestational age,parity and mode of production with the pregnant women in the control group,the difference was not statistically significant(P>0.05).2.The main manifestations of the observation group and the control group were the chorioamnionitis,the increase of the chimeric cell nodules,the villous interstitial fibrosis and the placental calcification.The amniotic fluid group showed 28 cases of chorioamnionitis,25 cases of syncytial nodules,15 cases of villous interstitial fibrosis and11 cases of placental calcification.The control group had 10 cases of chorioamnionitis,syncytiotrophoblast nodules increased in 9 cases,villous interstitial fibrosis in 1 cases,3cases of placental calcification.Compared with the control group,the placenta in the amniotic fluid group was more likely to have the placental pathological changes,and the difference was statistically significant(P<0.05).3.The positive rate of HIF-1 alpha in the observation group was 92.5%,and the positive rate of HIF-1 a in the control group was 42.5%,and the difference was statistically significant(P<0.05).4.The adverse pregnancy outcomes in the observation group and the control group included fetal distress,neonatal asphyxia,neonatal inhalation pneumonia and so on.There were 12 cases of fetal distress,5 cases of aspiration pneumonia and 3 cases of neonatal asphyxia(2 cases of severe neonatal asphyxia and 1 cases of mild neonatal asphyxiain)the observation group.There were 4 cases of fetal distress,1 cases of aspiration pneumonia and 1 cases of neonatal asphyxia(Mild).The incidence of adverse pregnancy outcomes in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).Conclution:1.The pathological changes of placenta in stage II and III degree amniotic fluid faeces include chorioamnionitis,placental villous syncytial nodule formation,villous interstitial fibrosis and villous calcification.2.The expression of HIF-1αin the placenta was elevated in the placenta of II and III degree amniotic fluid,indicating that the placenta was in a state of hypoxia.3.The pathological changes of the placenta with II and III degree amniotic fluid are closely related to the adverse pregnancy outcome.Therefore,the routine examination of placenta in the parturient with amniotic fluid infection can guide the diagnosis and treatment of the pregnant women and the newborns. |
PDF Full Text Request