引言胎盘在正常妊娠的常规评估中经常被忽视,只有在发现异常时才会引起注意。胎盘厚度可以很好地预测胎儿的生长和出生体重,尤其是在妊娠中期。在这项前瞻性研究中,我们测量了单胎妊娠中期和中期的胎盘厚度,并确定了胎盘厚度与不良结局(如先天性异常)之间的关联。胎儿生长受限(FGR),早产,低出生体重,死产,和胎儿水肿。方法对298例年龄20~33岁的患者进行单胎妊娠和规律周期妊娠,他们确定了最后一次月经期的日期,被观察到。在18-20周和30-32周通过超声测量胎盘厚度,将患者分为三组。A组由胎盘厚度正常的患者组成。B组包括具有薄胎盘(低于第10百分位数)的患者。C组由胎盘厚的患者组成(高于第95百分位数)。观察胎盘厚度与胎儿及新生儿结局的相关性。结果298例患者中,初生者82例(27.5%),多胎者216例(72.4%)。在18-20周,C组1例(7.69%)早产,B组6例(20%)早产,与A组的8名患者(3.14%)相比,在30-32周时,C组2例(16.67%)早产,B组11例(36.67%)早产,与A组的两名患者(0.78%)相比,在妊娠18-20周时,C组3例(23.08%),B组16例(53.33%)低出生体重,与A组的15例患者(5.88%)相比,在30-32周时,C组中有4例(33.33%)和B组中有19例(63.33%)低出生体重,而A组中有11例(4.30%)低出生体重.两名患者(13.33%)在18-20周时有严重的先天性异常和厚的胎盘。C组,在18~20周时有2例患者(15.38%)和30~32周时有2例患者(16.67%)出现积液.在厚厚的胎盘和积水之间发现了显着的关联。在30-32周,B组中有13例患者(43.33%)发生FGR,而6例患者(2.34%)胎盘正常。发现薄胎盘与FGR之间存在显着关联。一名胎盘厚的患者(7.69%)死产,表明无显著关联。结论先天性异常和积水与厚厚的胎盘呈正相关。而FGR,早产,早产,低出生体重与胎盘薄有关。特定胎龄的胎盘厚度异常可能是FGR的最早迹象。超声检查确定的异常胎盘应提醒临床医生围产期结局受损的可能性以及评估和密切随访的必要性。
Introduction The placenta is often overlooked in the routine evaluation of normal gestations, receiving attention only when abnormalities are detected. Placental thickness can serve as a good predictor of fetal growth and birth weight, especially in the second trimester.In this prospective study, we measured placental thickness in the second and third trimesters of singleton pregnancies and identified an association between placental thickness and adverse outcomes such as congenital anomalies, fetal growth restriction (FGR), prematurity, low birth weight, stillbirth, and
hydrops fetalis. Methodology A total of 298 patients aged 20 to 33 years with a singleton pregnancy and regular cycles, who were sure of the date of their last menstrual period, were observed. Placental thickness was measured by ultrasound at 18-20 and 30-32 weeks, and patients were divided into three groups. Group A consisted of patients with normal placental thickness. Group B included patients with a thin placenta (below the 10th percentile). Group C consisted of patients with a thick placenta (above the 95th percentile). The correlation between placental thickness and the fetal and neonatal outcome was observed. Results Out of 298 patients, 82 (27.5%) were primigravida and 216 (72.4%) were multigravida. At 18-20 weeks, premature birth was observed in one patient (7.69%) in Group C and six patients (20%) in Group B, compared with eight patients (3.14%) in Group A. At 30-32 weeks, premature birth was seen in two patients (16.67%) in Group C and 11 patients (36.67%) in Group B, compared with two patients (0.78%) in Group A. At 18-20 weeks of gestation, low birth weight was observed for three patients (23.08%) in Group C and 16 patients (53.33%) in Group B, compared with 15 patients (5.88%) in Group A. At 30-32 weeks, low birth weight was observed for four patients (33.33%) in Group C and 19 patients (63.33%) in Group B compared with 11 patients (4.30%) in Group A. A significant association was found between a thin placenta and low birth weight and prematurity at both 18-20 and 30-32 weeks of gestation. Two patients (13.33%) had major congenital abnormalities and a thick placenta at 18-20 weeks. In Group C,
hydrops were observed in two patients (15.38%) at 18-20 weeks and two patients (16.67%) at 30-32 weeks. A significant association was found between a thick placenta and
hydrops. At 30-32 weeks, 13 patients (43.33%) in Group B had developed FGR compared with six patients (2.34%) with a normal placenta. A significant association was found between a thin placenta and FGR. One patient (7.69%) with a thick placenta had a stillbirth, indicating a nonsignificant association. Conclusions A positive correlation was observed between congenital anomalies and
hydrops and a thick placenta, whereas FGR, preterm labor, prematurity, and low birth weight were associated with a thin placenta. Subnormal placental thickness for a particular gestational age may be the earliest sign of FGR. A sonographically identified abnormal placenta should alert clinicians to the possibility of a compromised perinatal outcome and the need for evaluation and close follow-up.