| Purpose:Through the analysis of the clinical characteristics,mode of delivery,maternal outcome and placental histology of placenta thickening in different gestational weeks,the relationship between placental thickening and adverse pregnancy outcome is explored in the research,improving the understanding of placental thickening.Methods:Clinical data about ultrasound examination report of 168 cases pregnant womenprompted single births and placenta thickening was collected from a class 3 first level general hospital during January 1,2012 to December 31,2014.According to the different gestational weeks,they were divided into A,B,C three groups: group A,pregnancy 18 to 28 weeks;group B,pregnancy 28 ~ 33 +6weeks;group C,34 to 41 weeks.The clinical features,mode of delivery,maternal outcome and placental histology were analyzed retrospectively,and compared with the pregnancy outcomes of 14364 cases of singleton,normal placenta thickness pregnant women of our hospital in 2014.Results:1.168 cases of pregnant women placenta thickness of 3.6 ~ 8.1cm,an average of5.59 ± 0.86 cm.The thickness of placenta in group A,B and C were 5.22 ± 0.96 cm,5.59 ± 0.90 cm and 5.82 ± 0.68 cm respectively.2.Placenta thickening pregnant women preeclampsia(13.1% vs2.3%)、Pregnancy with anemia(42.9% vs 32.6%)、Placental abruption(10.1% vs0.9%)、Oligohydramnios(11.3% vs3.4%)、Postpartum hemorrhage(8.3% vs 1.8%)、Fetal distress(13.2% vs 6.3%)、Less than gestational age(SGA,16.5% vs 3.0%)、Cesarean section rate(52.1% vs 34.9%)、Preterm birth(25.6% vs8.5%)、the incidence of neonatal treatment(57.0% vs10.3%)was higher than that of placenta accreta(P <0.05).Both gestational diabetes mellitus(GDM,17.3% vs 19.9%)had no significant difference(P> 0.05).The incidence of alpha-thalassemia in group A was the highest,the highest incidence of preeclampsia in group B,and the highest incidence of GDM in group C.3.Pregnant placenta thickened fetus fetal loss rate(28.0%)was higher than that without placenta thickening(4.4%).A,B,C group of three fetal loss rates were 47.7%,38.0% and 9.5%,the difference was statistically significant(P = 0.000).Placental thickening combined with fetal malformations in 22 cases,fetal loss in 20 cases,the loss rate of 90.9%(20/22),placental thickening with fetal edema in 35 cases,30 cases of fetal loss,loss rate of 85.7%(30/35).4.168 cases of placenta thickening of pregnant women in 27 cases with placental blood pool(27 / 168,16.1%),The incidence of placental blood pool was 34.1%,12.0%,8.1%,Group A: fetal edema rate of 29.5%(13/44),fetal malformations rate of 20.5%(9/44);B group: fetal edema rate of 32%(16/50),fetal malformations rate of 22.0%(11/50);C group fetal edema rate of 8.1%(6/74),fetal malformations rate of 2.7%(2/74).5.60 cases of placental thickening patients with placental pathology,the rate was 35.7%.The highest detection rate was 48.3%(29/60)of villous infarction,followed by placental thrombosis,placental villus around the cellulose deposition,calcium deposition,were 45%(27/60).14 patients were diagnosed with choriocarcinoma,the detection rate was 23.3%.Conclusions:1.Placental thickness increases with gestational age.The most common ultrasound manifestations of placental thickening are placental blood pool,fetal edema and fetal malformations.2.Placental thickness is related with adverse pregnancy outcomes,placental thickness can be used as an important measure of prenatal ultrasound.3.High fetal loss rate happens with the diagnosis of placental thickening before 34 th weeks.Placental thickening combined with fetal edema,fetal malformations are risk factors for fetal loss.4.The histopathological changes of placental thickening are mainly infarction and thrombosis,suggesting placental thickening patients with placental circulation dysfunction.Placental thickening patients’ placental choriocarcinoma detection rate is high,intrauterine infection should be alerted. |
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