胎盘血管瘤的临床诊治探讨——附19例病例分析
浙江大学医学院附属金华医院, 产科, 浙江金华 321000
| 摘 要： | 目的：探讨胎盘血管瘤的临床特征、对母儿的不良影响及诊治措施，为提高临床诊疗水平及降低母儿不良结局的发生提供参考依据。方法：收集2010年1月至2021年12月金华市中心医院确诊的19例胎盘血管瘤，回顾性分析孕产妇的临床资料，观察指标包括胎盘血管瘤的检出孕周、部位及体积，胎盘血管瘤相关并发症，母儿结局等，统计分析其临床特点及诊治转归等。结果：本院胎盘血管瘤的发病率低，人数占同期本院分娩人数的0.16%。胎盘血管瘤并发症的临床特征呈多样化，包括羊水过多、胎膜早破、胎儿水肿等。胎儿面与母体面胎盘血管瘤病例组比较中，胎儿面病例组的瘤体检出孕周较早及瘤体体积较大（P<0.05），发病人数较多。有并发症组与无并发症组比较中，有并发症组瘤体检出孕周较早，瘤体体积较大，胎儿面血管瘤人数较多（P<0.05）。早产组与足月产组比较中，早产组瘤体体积较大，瘤体检出孕周较早，有胎盘血管瘤并发症的人数较多（P<0.05）。剖宫产组与阴道分娩组比较中，剖宫产组瘤体检出孕周较早，瘤体体积较大，有胎盘血管瘤并发症的人数较多（P<0.05）。结论：胎儿面胎盘血管瘤较母体面胎盘血管瘤常见，易发生巨大胎盘血管瘤且瘤体检出孕周较早。胎盘血管瘤的并发症常呈多样化。瘤体检出孕周较早（中期妊娠）、体积巨大的胎盘血管瘤及合并胎盘血管瘤并发症的情况，可增加早产及剖宫产风险。 |
| 关 键 词： | 胎盘血管瘤; 并发症; 早产 |
| DOI： | 10.57237/j.wjcm.2023.04.001 |
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收稿日期: 2023-08-11
接受日期: 2023-10-31
在线出版日期: 2023-11-15
Clinical Diagnosis and Treatment of Placental Hemangioma: An Analysis of 19 Cases
Department of Obstetrics and Gynecology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, China
| Abstract: | Objective: To investigate the clinical features of placental hemangioma, so as to provide advice for diagnosis and treatment. Methods: The clinical data of 19 patients with placental hemangioma admitted to Jinhua Central Hospital from January 1, 2010 to December 31, 2021 were retrospectively analyzed. These cases were divided into group A (complication), group B (no complication); C group (premature birth), D group (term birth); Group E (fetal face) and group F (maternal face). Their clinical characteristics and outcomes of diagnosis and treatment were summarized. Results: The incidence of placental hemangioma accounted for 1.6% of pregnant women. In the case group with complications related to placental hemangioma during pregnancy, the maximum diameter of the tumor was higher than that in the case group without complications related to placental hemangioma, and the gestational age was lower than that in the case group without complications related to placental hemangioma. The composition ratio of the number of people with complications of placental hemangioma and the longest diameter of the placental hemangioma at termination of pregnancy were significantly higher than those in the term group, and the gestational age of placental hemangioma in the preterm group was significantly lower than that in the term group. The longest diameter of the tumor at termination of pregnancy in the placental hemangioma case group on the fetal side of the placenta was significantly higher than that in the placental hemangioma case group on the maternal side of the placenta. The incidence of placental hemangioma on the fetal side was significantly lower than that in the maternal side. Conclusions: Placental hemangioma on the fetal surface is more common than placental hemangioma on the maternal surface. Giant placental hemangioma is more likely to occur and the tumor is detected earlier in gestation. The complications of placental hemangioma are often diverse. Tumors detected at an early gestational age (mid-trimester), huge placental hemangioma, and complications of placental hemangioma can increase the risk of premature delivery and cesarean section. |
| Keywords: | Placental Hemangioma; Complications; Premature Birth |
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