- 作者：Pia Wintermark ; Theonia Boyd ; Matthew C. Gregas ; Michelle Labrecque ; Anne Hansen
- 关键词：hypothermia ; hypoxic-ischemic encephalopathy ; newborn ; placenta
- 刊名：American Journal of Obstetrics and Gynecology
- 出版年：2010
- 出版时间：December 2010
- 年：2010
- 卷：203
- 期：6
- 页码：579.e1-579.e9
- 全文大小：1898 K
Objective
We sought to describe placental findings in asphyxiated term newborns meeting therapeutic hypothermia criteria and to assess whether histopathologic correlation exists between these placental lesions and the severity of later brain injury.Study Design
We conducted a prospective cohort study of the placentas of asphyxiated newborns, in whom later brain injury was defined by magnetic resonance imaging.
Results
A total of 23 newborns were enrolled. Eighty-seven percent of their placentas had an abnormality on the fetal side of the placenta, including umbilical cord lesions (39 % ), chorioamnionitis (35 % ) with fetal vasculitis (22 % ), chorionic plate meconium (30 % ), and fetal thrombotic vasculopathy (26 % ). A total of 48 % displayed placental growth restriction. Chorioamnionitis with fetal vasculitis and chorionic plate meconium were significantly associated with brain injury (P = .03). Placental growth restriction appears to significantly offer protection against the development of these injuries (P = .03).
Conclusion
Therapeutic hypothermia may not be effective in asphyxiated newborns whose placentas show evidence of chorioamnionitis with fetal vasculitis and chorionic plate meconium.