羊水粪染与绒毛膜羊膜炎关系探讨

The relationship between meconium-stained amniotic fluid and chorioamnionitis

目的:探讨Ⅱ～Ⅲ度羊水粪染与绒毛膜羊膜炎的关系及对围生儿的影响。方法:对2010年2～8月因羊水Ⅱ～Ⅲ度粪染行胎盘病理检查的236例临床资料进行回顾性分析。结果:在236例Ⅱ～Ⅲ度羊水粪染病例中,胎盘病理检查有组织学绒毛膜羊膜炎病例多于无组织学绒毛膜羊膜炎病例,重度绒毛膜羊膜炎新生儿窒息发病率较无急性绒毛膜羊膜炎和轻、中度急性绒毛膜羊膜炎病例高(P<0.05),有组织学绒毛膜羊膜炎与无组织学绒毛膜羊膜炎的胎盘病理表现基本相同(P>0.05)。结论:Ⅱ～Ⅲ度羊水粪染与绒毛膜羊膜炎密切相关;绒毛膜羊膜炎引起绒毛及血管病变是导致羊水粪染、胎儿窘迫、新生儿窒息原因之一。在临床工作中对羊水Ⅱ～Ⅲ度粪染病例应常规行胎盘病理检查,有利于诊断及指导孕产妇和新生儿的治疗。

Objective：To study on the relationship between meconium-stained amniotic fluid of Ⅱ～Ⅲ degree and chorioamnionitis and the effect of meconium-stained amniotic fluid on perinatal children.Methods：236 patients who were done placental pathology because of II-Ⅲ degree meconium-stained amniotic fluid from February,2010 to August,2010 in our hospital were retrospectively analyzed.Results：In 236 cases of II-Ⅲ degree meconium-stained amniotic fluid,the patients with histologically chorioamnionitis were more than the patients without histologically chorioamnionitis（64.41%） by placental pathology,the incidence of neonatal asphyxia with severe chorioamnionitis was higher than those without acute chorioamnionitis and mild acute chorioamnionitis（P0.05）.The placental pathology was same between histologic chorioamnionitis and no histological chorioamnionitis（P0.05）.Conclusion：II-Ⅲ degree meconium-stained amniotic fluid is closely related with the chorioamnionitis;Chorioamnionitis caused by vascular disease is one of the reasons to lead meconium-stained amniotic fluid,fetal distress,neonatal asphyxia..Placental pathology should be done for the patients with II-Ⅲ degree meconium-stained amniotic fluid,witch is useful for diagnosis and treatment.