国际妇产科学杂志 ›› 2012, Vol. 39 ›› Issue (6): 574-577.

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病理性绒毛膜羊膜分离的研究现状

李满超,方 群   

  1. 510080 广州,中山大学附属第一医院胎儿医学中心
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2012-12-15 发布日期:2012-12-15
  • 通讯作者: 方 群

Current Status of Pathological Chorioamniotic Membrane Separation

LI Man-chao,FANG Qun   

  1. Fetal Medicine Center,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China
  • Received:1900-01-01 Revised:1900-01-01 Published:2012-12-15 Online:2012-12-15
  • Contact: FANG Qun

摘要: 绒毛膜羊膜分离可分为生理性与病理性,妊娠14周前为生理性分离,妊娠14周及以后则为病理性分离。胎膜损伤是导致病理性绒毛膜羊膜分离的主要原因,介入性宫内诊断或干预都要经过子宫肌层及羊膜腔,导致胎膜损伤,范围较小的绒毛膜羊膜分离无临床意义,范围较大的明显增加胎膜早破、感染、早产、羊膜带综合征和胎死宫内的发生率,目前尚无有效的预防及治疗方法。少部分病理性绒毛膜羊膜分离是自然发生的,与基因突变或染色体非整倍体有关,预后不良,应终止妊娠。

关键词: 绒毛膜, 羊膜, 产前诊断, 羊膜腔穿刺术, 胎儿镜检查, 妊娠结局

Abstract: Chorioamniotic membrane separation(CMS)consists of physiological and pathological form.Physiological CMS occurred before 14 gestational weeks, CMS developed after 14 gestational weeks. The damage of the fetal membrane is the initial factor of the pathological CMS. Interventional intrauterine diagnosis or treatment procedures have to pass through the unterine wall and amniotic cavity which universally causes the damage of membrane.The mild CMS had no clinical presentation, however severe CMS could increases the risk of preterm rupture of membrane,intrauterine infection,preterm delivery,amniotic band syndrome, intrauterine death. At present,more researches are needed in order to prevent the occurrence of CMS after invasive procedures. The minority of CMS is spontaneous,which is related to aneuploidy or gene mutation.The termination was mostly needed because of poor prognosis.

Key words: Chorion, Amnion, Prenatal diagnosis, Amniocentesis, Fetoscopy, Pregnancy outcome