胎儿死亡的胎盘病理

人类胎盘是一个妊娠期的临时器官,对胎儿发育和正常妊娠的维持起重要作用。妊娠期间,胎盘在母体和胎儿间建立沟通的桥梁,为胎儿提供营养物质,进行气体交换和废物清除,并建立免疫耐受环境,保障半异体胎儿不被母体排斥;胎盘还可作为妊娠期重要的内分泌器官,协调胎儿发育及母体多器官的妊娠适应性应答。胎盘发育不良往往导致胎儿生长异常及多种妊娠并发症,严重情况下可导致胎儿死亡。文章阐述了生理状况下人类胎盘的结构和功能,描述了因胎儿生长受限(FGR)、子痫前期(PE)、妊娠期糖尿病(GDM)等造成胎儿死亡的胎盘病理特征,进而展望通过靶向胎盘干预妊娠期疾病的可能前景。

Placental pathology of the fetal death

The placenta is a temporary organ existing during pregnancy，which is critical to fetal development and pregnancy maintenance.It is the only place where the fetus exchanges nutrients and gases with the mother and clears metabolic waste during pregnancy.An immunotolerant environment is established in the placenta to ensure that the semi-allograft fetus is not rejected by the mother.In addition，the placenta is an important endocrine organ to modulate the pregnancy adaptation response of the maternal organs to the growing fetus.Disorders in placental development will cause various pregnancy diseases，hamper the fetal development and even lead to fetal death.In this article，we briefly introduce the physiological events of placental cell differentiation and function，and summarize the knowledge on the pathological properties of the placentas for the lethal fetuses derived from fetal growth retardation（FGR），preeclampsia（PE）or gestational diabetes mellitus（GDM）.The prospect of intervening the pregnancy diseases by targeting the placentas is discussed.