■患有心血管疾病(CVD)的妇女怀孕的发病率增加,然而,对这些女性的胎盘病理知之甚少。
■本研究的目的是描述妊娠合并母体CVD的胎盘病理,并比较母体CVD类别之间的发现。
■回顾,进行了单中心研究。对264例妊娠合并母体CVD的胎盘的病理报告进行了回顾,以了解预定的病理结果,然后将其与母体特征进行比较。
■胎盘来自与母亲先天性心脏病相关的妊娠(n=171),心律失常(n=43),心肌病(n=20),结缔组织病(n=20),和心脏瓣膜病(n=10)。产妇分娩时的中位年龄为32岁(范围:19-49岁)。分娩时的中位胎龄为39周(范围:25-41周)。在75%(199/264)的胎盘中发现了胎盘病理。解剖病理学,主要是小胎盘重量,存在于45%(119/264)的胎盘中。血管病理学,主要是母体血管灌注不良或胎儿血管灌注不良,在41%(107/264)的胎盘中可见。急性绒毛膜羊膜炎和不明原因绒毛膜炎(VUE)见于23%(61/264)和11%(28/264)的胎盘,分别。VUE的患病率因CVD类别而异(P=0.008),在母体先天性心脏病中最常见;在解剖学上没有差异,传染性,和跨心血管疾病类别的血管病变。
■患有心血管疾病的妇女的妊娠通常表现为胎盘异常,尤其是解剖和血管病理学.VUE的患病率因CVD类别而异。否则,具体病理结果的发生率根据母体特征没有差异.
UNASSIGNED: The incidence of pregnancy in women with cardiovascular disease (CVD) has increased, yet little is known about placental pathology in these women.
UNASSIGNED: The objectives of this study were to describe placental pathology in pregnancies complicated by maternal CVD and to compare findings among categories of maternal CVD.
UNASSIGNED: A retrospective, single-center study was conducted. Pathology reports for 264 placentas from pregnancies complicated by maternal CVD were reviewed for prespecified pathologic findings which were then compared against maternal characteristics.
UNASSIGNED: Placentas were from pregnancies associated with maternal congenital heart disease (n = 171), arrhythmia (n = 43), cardiomyopathy (n = 20), connective tissue disease (n = 20), and valvular heart disease (n = 10). Median maternal age at delivery was 32 years (range: 19-49). Median gestational age at delivery was 39 weeks (range: 25-41). Placental pathology was identified in 75% (199/264) of placentas. Anatomic pathology, primarily small placenta by weight, was present in 45% (119/264) of placentas. Vascular pathology, primarily maternal vascular malperfusion or fetal vascular malperfusion, was seen in 41% (107/264) of placentas. Acute chorioamnionitis and villitis of unknown etiology (VUE) were seen in 23% (61/264) and 11% (28/264) of placentas, respectively. Prevalence of VUE differed across CVD categories (P = 0.008) and was most common in maternal congenital heart disease; there were no differences in anatomic, infectious, and vascular pathologies across CVD categories.
UNASSIGNED: Pregnancies among women with CVD commonly demonstrate abnormal placental findings, especially anatomic and vascular pathology. Prevalence of VUE differed across CVD categories. Otherwise, the incidence of specific pathology findings did not differ based on maternal characteristics.