子宮内胎児発育遅延における絨毛の抗血栓機能の意義に関する研究

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It is suggested that a hemoconcentration and hypercoagulation are strongly related to the onset of intrauterine growth retardation (IUGR) through the deterioration of the placental circulation. The chorionic villi in the placenta will maintain the microcirculation and fetomaternal transportation in the placenta by its strong anticoagulant activity, which is affected with maternal blood hypercoagulation. In this study, two kinds of anticoagulant (maltose-heparin (M-H) or antithrombin III (ATIII)) were given to pregnant women with IUGR. The patients were divided into two groups according to their maternal hematocrit (Hct) levels, a normal Hct (N-H) group (32.4 ± 1.3%, mean ± SE) and a high Hct (H-H) group (40.0 ± 0.5%). The M-H therapy was effective in the N-H group (the increment of estimated fetal body weight measured by ultrasound was 26.6 ± 3.7 g/day), but it was not effective in the H-H group (11.1 ± 2.1 g/day), while the ATIII therapy was effective in the H-H group (20.6 ± 4.0 g/day). To clarify the effects of ATIII on the placental circulation, the culture system of chorionic villi was applied. By the addition of ATIII to the culture medium, the production and release of prostacyclin by villous cells and the contents of cellular thrombomodulin, which acts as an inhibitor of thrombin, which acts as an inhibitor of thrombin, were significantly increased. It is suggested that ATIII therapy will improve placental circulation through the increase of anticoagulant activity in the chorionic villi, all of which result in the improvement of IUGR.
東京女子医科大学の論文
1997-12-25

子宮内胎児発育遅延における絨毛の抗血栓機能の意義に関する研究

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