子痫前期与宫内死胎的相关性研究进展

Research Progress on the Relationship Between Preeclampsia and Intrauterine Fetal Death

子痫前期(preeclampsia,PE)是一种动态进展的妊娠相关性疾病,病因具有异质性,是导致孕产妇和胎儿死亡的主要原因之一。正常胎盘的形成是维持胎儿正常生长发育的关键。不正常的胎盘植入被认为是子痫前期的主要发病机制,以胎盘浅着床为中心环节。宫内死胎是一种由多因素导致的严重的妊娠期并发症,60%的宫内死胎与胎盘有关,给孕妇及家属造成严重的心理负担,近年来成为产科关注热点和难点。PE被认为是宫内死胎的一个独立危险因素,可能与滋养细胞浅层浸润、螺旋动脉生理性重铸失败导致母体血流灌注不良及血管内皮损伤有关。改善PE的血管重铸和子宫胎盘重塑,可能逆转妊娠期血压升高从而降低宫内死胎的发生率。

Preeclampsia(PE)is a dynamic progress of pregnancy related diseases,the etiology is heterogeneous,is one of the main causes of maternal and fetal death.The formation of normal placenta is the key to maintain the normal growth and development of fetus.Abnormal placenta accreta is considered to be the main pathogenesis of preeclampsia,with shallow placental implantation as the central link.Intrauterine fetal deathis a serious pregnancy complication caused by many factors.60%of intrauterine fetal death is related to placenta,which causes serious psychological burden to pregnant women and their families.In recent years,it has become a hot and difficult point in obstetrics.PE is considered to be an independent risk factor for intrauterinefetal death,which may be related to the superficial infiltration of trophoblast,the failure of physiological recast of spiral artery leading to poor maternal blood flow perfusion and vascular endothelial damage.The improvement of vascular recasting and uterine placental remodeling of PE may reverse the increase of blood pressure during pregnancy and reduce the incidence of intrauterine fetal death.