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["表. 胎盤病理所見"]
[]
["部位",null,"分類",null,"病変(正常妊娠末期)","病理","原因","合併症"]
["臍帯",null,"動脈",null,"plate隣接2cm以内での癒合","two-vessel cord (single umbilical artery)\n","primary agenesis, atrophy","anomaly 20%、染色体異常、IUGR、周産期死亡"]
[null,null,"静脈"]
[null,null,null,null,null,"more than three vessels","cord varicoses, persistent vitelline vessels, allantoic duct, umbilical angioma, conjoined twins\n"]
[null,null,"Wharton's jelly",null,"減少、Mφ"]
[null,null,"長さ",null,"正常　55±12, 60±13cm\n新生児付着分3cmを考慮すること","short: <32cm, long: 70, 100cm<","long: increased fetal movement, short: decreased fetal movement\n","long: nuchal cord臍帯巻絡, cord prolapse臍帯脱出, funic presentation, 臍帯結節、臍帯血栓、\nshort: amnion band, anomaly、臍帯破裂・血腫、神経障害、羊水過少"]
[null,null,"太さ",null,"正常 <32W: <0.8-1.5cm, term: 1-2cm",null,"increased: focal (intrafunicular lesion), diffuse (infection, hydrops, diabetes, TTTS), decreased IUGR, IUFD, preeclampsia\n"]
[null,null,"狭窄　stricture",null,null,"Wharton jelly loss",null,"IUFD"]
[null,null,"捻転",null,"coiling: 12±6<25, coiling pitch=単位捻転/太さ＝（長さ/捻転数）/太さ＝5±4.5、過捻転≦2, 0.3coil/cm≦\n"]
[null,null,"結節 knot",null,"true, false",null,null,"true knot 真性結索：高度結索でIUFD10％、臍帯血管血栓、\nfalse knot 偽結索：臍帯血管蛇行、臨床的意義無し"]
[null,null,"炎症 funisitis",null,null,"Nakayama分類：acute funiculitis/funisitis: Ⅰ°:静脈内皮PMN, Ⅱ°:静脈筋層PMN, Ⅲ°:Wharton内PMN, \nBlanc, 1981 fetal inflammatory response:　stage 1 umbilical phlebitis or chorionic vasculitis of PMN, stage 2 arteritis, stage 3: necrotizing funisitis: PMN or debis concentric band ring halo around umbilical vessels, Grade 1: non-severe, Grade 2: severe \n ",null,"前期破水、経膣感染、表面白斑：カンジダ感染"]
[null,null,"血栓　thrombosis",null,null,null,"abnormal fetal circulation, infection","IUGR, distress, IUFD"]
[null,null,"外傷",null,"裂傷、捻転"]
[null,null,"潰瘍",null,null,null,null,"消化管閉鎖、潰瘍面より大量出血"]
[null,null,"amnionic web",null,null,"臍帯付着部近傍における卵膜癒着",null,"臍帯動き制限、血流障害、\nDD amniotic band\n"]
[null,null,"hematoma",null,null,null,null,"fetal death, anemia"]
[null,null,"腫瘍",null,"奇形腫、血管腫",null,null,"血管腫：胎児DIC、胎児水腫、胎児死亡"]
[null,null,"遺残",null,null,"omphalomesenteric duct remnant, yolk sac, allantoic remnant, vitelline vessels\n",null,"意義なし"]
["臍帯の胎盤付着部位",null,"付着部位",null,null,"central, paracentral,\nparamarginal, marginal<1cm辺縁, \nvelamentous\n\n",null,"臍帯辺縁付着 marginal cord insertion：IUGR, 死産、周産期死亡、未熟児、低出生体重児、,\n臍帯卵膜付着 velamentous cord insertion: vasa previa、血管破裂、胎盤機能不全、胎児期形、双胎\n"]
["胎盤",null,"重量","重い90%<、厚さ3cm＜","高重量胎盤 high placental weight",null,null,"anemia, distress, TORCH infection, hydrops、胎児心不全、母体糖尿病、栄養不良、後血腫、腫瘍、梅毒\n"]
[null,null,null,"軽い<10%","低重量胎盤 low placental weight",null,null,"preeclampsia妊娠高血圧症候群,腎症合併糖尿病 IUGR, maternal disease, 慢性感染症infection, trisomy、重症溶血性貧血\n"]
[null,null,"形","discoid",null,"円盤；round, oval, triangular"]
[null,null,null,"pl. zonaria",null,"帯状zonary: incomplete (reniform), complete (annular)\n"]
[null,null,null,"pl. membracea, thin placenta 菲薄胎盤",null,"紙状：membranous, fenestrated\n厚さ＜2ｃｍ",null,"母体出血、前置胎盤、癒着胎盤、IUGR,早産"]
[null,null,null,"周郭胎盤　pl. circummarginata, c-marginate pl.,\n\n額縁胎盤　pl. circumvallata, circumvallate pl\n","extrachorial placentation:\nc-marginate: 3-25%頻度\nc-vallate: 2-18%頻度","画縁: flat white ring/rim: partial, marginal, total、有郭：web white ring","c-marginate: abnormal placental implantation or development,\nc-vallate: hemorrhage, PROM","multiparity, ealy fluid loss, IUGR, preeclampsia, bleeding during pregnancy (chorionic hemosiderosis), decidual necrosis、\n臨床的意義低い、\n出血の既往を示唆"]
[null,null,null,"pl. multilobata",null,"分葉： bi-, tri-, multi-",null,"abnormal hsape (lobe), accessory/succenturiate lobe：\n母体出血、着床異常、障害のある子宮内環境（筋腫、中隔、掻爬・帝王切開既往）"]
[null,null,null,"pl. multiplex","臍帯血管の分岐","多重　du-, tri-, multi-"]
[null,null,null,"pl. multipartita","第１胎盤臍帯付着部より娘胎盤へ血管連結\n","多分裂： bi-, tri-, multi-"]
[null,null,null,"pl. succenturiata, spuria","第１胎盤末梢より娘胎盤へ血管連結\n","副性: succenturide, accessory"]
[null,null,null,null,"第１胎盤と娘胎盤の血管連結不明\n","偽: sprious"]
[null,null,"多胎　multiple",null,"twin: T zone","1. DiDi: dichorionic-diamniotic, separated,\n2. DiDi, fused,\n3. MoDi,\n4. MoMo","70%:, 1. dizygotic, \n30%:, monozygotic, 2. 25%, 1-3 days, separation at blastomere, \n3. 75%, 4-7 days, at inner cell mass,\n4. 3%, 8-12 days, before germ disc,\n4'. 13 days<, after germ disc, conjoined twins (Siamese twins)","TTTS in 1/3 of monochorionic with anastomoses; TTTS criteria by Bruner JP, Am J Obstet Gynecol 1993;169925-30. 1. vascular anastomosis, 2. Hb difference 5g/dl, 3. BW diff. 20%<.. (echo: Mo, same sex, poly and oligo-hydramnios).\n\ntwin: vanishing twin, fetus papyraceus/compressus, acardiac twin\n\n"]
[null,null,"奇胎様",null,"間葉性異形性胎盤 placental mesenchymal dysplasia, PMD","巨大胎盤　1000g＜、絨毛増生（血管増生、血栓、浮腫）",null,"死産、IUGR、Beckwith-Wiedemann"]
[null,null,"癒着胎盤、子宮筋層浸潤",null,"Irving & Hertig classification:","０．付着胎盤：基底(/床)脱落膜有り\n１．狭義の癒着胎盤、楔入せつにゅう胎盤 pl. accreta、\n２．嵌入かんにゅう胎盤 increta,\n３．穿通胎盤 percreta\na.全 total , b. 部分 partial, c. 焦点 focal （1個胎盤葉 cotyledon）\n","着床部子宮内膜菲薄","娩出胎盤より摘出子宮の検索により確定される。帝王切開瘢痕・子宮内掻爬の既往、分娩後出血、胎盤遺残、再発リスク"]
["胎盤胎児面",null,"卵膜",null,"squamous metaplasia　扁平上皮化生",null,null,"臨床的意義無し"]
[null,null,null,null,"amnionic nodosum羊膜結節",null,"羊水過少：妊娠中後期","severe oligohydramnios, \npoor fetal lung development, \ncongenital absence or obstruction of urinary system, \nulceration of amnion、\n胎児腎機能障害、\nIUFD\n"]
[null,null,null,null,"amniotic band syndrome 羊膜索症候群",null,"rupture of membrane、羊水過少：妊娠早期","fetal amputation, constriction, disrupton, oligohydramnios"]
[null,null,null,null,"rupture site: normal>10cm from placental margin","at placental margin: pl previa, vasa previa, low-lying implantation\n"]
[null,null,null,null,"瀰漫性絨毛膜羊膜ヘモジデローシス diffuse chorioamnionic hemosiderosis, DCH",null,null,"慢性早期剥離羊水過少症候群 chronic abruption-oligohydramnios sequence, CAOS,\n新生児肺高血圧症、\n新生児慢性肺疾患"]
[null,null,null,null,"褐色色素貪食組織球、胎便付着　pigment laden macrophage, meconium-staining\n正常頻度：24-36W 7.9%, 37-42W 38.7%, 42<: 52.4%","1. acute: green-yellow (Mφwith meconium): 1-6時間：amnion, 3-6時間chorion, decidua, 6時間＜：cord, chorionic plate, 16時間＜: chronic meconium exposure (meconium-associated vascular necrosis of smooth muscle of cord; apoptosis as pyknotic nuclei), \n2. subacute: green-brown,\n\nDD. hemosiderin (Fe+),\n","予定日超過、\n仮死、\n消化管・腹壁奇形","amnion only: slight and short exposure to meconium, \nchorion: severe and longer exposure, \ncord: prolonged exposure,\n児予後不良：thin<thick粘稠\n臍帯血管攣縮\n胎便吸引症候群"]
[null,null,null,null,"遺残　youlk sac","calcified cyst"]
[null,null,null,"炎症、壊死","脱落膜炎 deciduitis、\n脱落膜壊死 decidual necrosis",null,null,"部分的：意義不明、\n広汎性：後血腫"]
[null,null,null,"出血","subamniotic hemorrhage",null,"分娩後artefact","traction of cord, iatrogenic laceration of surface vessels\n"]
[null,null,"絨毛膜（板）","異常","chorionic cyst"]
[null,null,null,null,"remnant of yolk sac"]
[null,null,null,"腫瘍","tumor: teratoma, hemangioma"]
[null,null,null,"炎症","化膿性絨毛膜羊膜炎（注意：妊娠月別の生理的出現頻度：7月：59%、8月：40%、9月：24%、10月：7%）","（急性化膿性）絨毛羊膜炎：母体血由来多核白血球浸潤：\nBlanc, 1981, maternal inflammatory response分類：　絨毛膜深部限局（stage 1）→絨毛膜中間部へ波及（stage 2）→羊膜炎（stage 3：necrotizing chorioamnionitis: PMN karyorrhexis, amnion necrosis, amniotic BM thickening）, Grade 1: non-severe, Grade 2 severe (PMN band aggregate, microabscess)\n","上行性感染症","前期破水、早産、子宮内感染、新生児脳炎"]
[null,null,"絨毛膜下","血腫","絨毛膜下血腫 subchorionic hematoma,\n高度絨毛膜下血栓 massive subchoionic thrombus （ブロイス奇胎 Breus' mole）",null,null,"狭い：臨床的意義無し、\n広範：流産、早産"]
["胎盤中間部",null,"絨毛内","発育異常","未熟絨毛 delayed matureation, retarded for dates, distal villous immaturity, delayed villous maturation","large villi with 2-layer trophoblast, few knots, increased Hofbauer cells, increased nucleated RBC with fetal anemia, edma\n妊娠後期：末端絨毛比率＜３０％、浮腫\n","unknow,\nfetal anemia, fetal heart failure, diabetes","胎児貧血、胎児心不全、母体糖尿病、子宮内発育遅延、胎児低酸素、染色体異常"]
[null,null,null,null,"irregular maturation, dysmaturity\n",null,"abnormal placental growth","trisomy 18, chronic villitis"]
[null,null,null,null,"早熟、過熟絨毛 accelerated maturation (with dista/peripherall villous hypoplasia),  accelarated for dates,\nreduced villous diameters\nterm: terminal 30%\n","small villi, increased syncytial knots, increased CT, thick BM,\n\n正常妊娠後期：stem25%, mature25%, terminal50%比率、\n早産例での成熟絨毛出現で確認可能\ntermでの診断は困難\n","unknown,\n母体血流不全 decreased maternal perfusion, decidual vascular insufficiency：中毒症","子宮内発育遅延, IUFD、妊娠高血圧症候群の早産、虚血"]
[null,null,null,null,"奇形型絨毛","異型絨毛（八手の葉、鋸歯状）、増生した合胞体芽、未熟絨毛\n",null,"子宮内発育遅延、胎児奇形"]
[null,null,null,null,"chorionic cyst"]
[null,null,null,null,"有核赤血球 nucleated RBC：\n 無し30週＜","mild: 2-3/villus, moderate: 3</villus, marked: immature erythroblast+\n",null,"fetal hypoxia, ischemia, erythroblastosis, fetal anemia, infection, distress, IUGR, 死産、未熟児、母体糖尿病、胎児血喪失（胎児間輸血症候群供血児）"]
[null,null,null,"炎症","化膿性絨毛炎 acute villitis and abscess","intervillous PMN aggregate, villous necrosis with PMN, infarct\n胎児血由来白血球浸潤：脈管内膜→周囲\n","上行性感染\nlisteria\n","母体重篤感染症、早産、子宮内感染、胎児死亡"]
[null,null,null,null,"絨毛炎、血行性","CMV: inclusion: eosinophilic intranuclear, basophilic intracytoplasmic, lymphoplasmacytic villitis, necrotizing vasculitis, vessel occlusion, stromal hemosiderin,\n \nHSV: necrotizing lymphocytic villitis,\n\nparbovirus B19: IUFD 20-28W, large placenta, edematous villi, nucleated RBC, eosinophilic intranuclear inclusion,\n\nsyphilis: large placenta, immature villi, fetal vascularization, chronic or active villitis,\n\ntoxoplasmosis: fibrosis, granuloma, plasma cell deciduitis, nucleated RBC, chronic CAM, funisitis, thrombosis and calcification of chorionic plate vessel\n","virus: CMV, rubella, varicella, parvovirus, HSV,\nbacteria: syphilis, listeria,\nparasite: toxoplasma","Rubella: abortion, Parvo: IUFD, Rubella/Toxo: anomaly, Toxo/CMV: infection, CMV et al: sequelae: deafness, mental retardation, learning disability\n"]
[null,null,null,null,"原発性絨毛炎 (villitis of unknown etiology)、慢性絨毛炎 chronic villitis, unknown etiology (VUE)\n\nvillitisの95％＜\n\nintravillous cells: fetal+maternal, intervillous cells: maternal 、","絨毛内（母体T？）リンパ球浸潤、血管増生、稀にB細胞、Langhans型細胞、形質細胞、\n所見記載：\ntype: acute, chronic granulomatous,\ncomposition: lymph, histio, plasma, PMN,\nnercoris: necrotizing or non-n.,\ndistribution: focal, diffuse, basal,\nseverity: Knox & Fox, 1984: Grading:\nⅠ°:few villi/focusx1-2 foci/4 slides,\nⅡ°:20 villi/focusx6 foci,\nⅢ°:50% of LPF,\nⅣ°:most LPF,\nまたは\n1a: low grade: <10 villi/cluster, 1b: high grade: 10 villi/cluster, \n2a. Patchy: <5%, 2b: diffuse: 5%<\n","不明","生理的着床現象、\n90%原因不明、\n子宮内発育遅延、感染症TORCH,梅毒、 maternal immune rejection"]
[null,null,null,null,"eosinophilic/T-cell vasculitis",null,"unknown fetal origin"]
[null,null,null,null,"慢性組織球性絨毛間炎 chronic perivillositis, chrnoic histiocytotic intervillositis",null,null,"習慣性流産、早産"]
[null,null,null,"浮腫 villous edema","浮腫：妊娠早期２．３月には生理的","浮腫","生理的 immature intermideate villi, reduced drainage of fetal blood\n\n","部分的：意義無し、\n瀰漫性：糖尿病, fetal compromise in CAM, preeclampsia, TORCH, 胎児水腫、胞状奇胎、神経学的異常\n"]
[null,null,null,"血栓","胎児血管閉塞：\nmural thrombi in chorionic or large fetal stem\n古典的血栓：10月以降は生理的 4.5, 10%頻度\n","血栓\nlocation: marginal, central/eccentric\nsize: <1cm, 1cm<\ncolor: red:<3d, pink:<5d, white: 7d<","生理的, ","生理的、上行性感染、慢性絨毛炎、コカイン、胎盤内血流異常、早産、decidual vascular pathology, 多胎、IUGR"]
[null,null,null,null,"出血性血管内膜炎 hemorrhagic endovasculitis/endovasculosis, HEV","破砕赤血球, intimal and medial hyperplasia","poor fetal blood flow, CMV, DIC, hypoxia, endothelial damage, hypoxia, long cord\n","稽留子宮内胎児死亡：死後変化、胎便付着、死産、IUGR、神経障害、母体高血圧、梗塞、血管腫、子宮内血流異常、胎児心拍異常、胎児仮死"]
[null,null,null,null,"obliterative endarteritis 生理的10%頻度","stem villi:: intimal hyperplasia","uteroplacental ischemia","preeclampsia, diabetes mellitus, rh incompatibility, smoking"]
[null,null,null,null,"fibromuscular sclerosis","stem villi: intimal fibrosis and fibromuscular proliferation of media, obliterated lumen, \nfibrosis or infarct of supplied periphery,\n\ndiffuse: IUFD\n\n\n\n","lack of blood flow after IUFD"]
[null,null,null,null,"胎児絨毛血管血栓症 fetl artery thrombosis,\n無血管絨毛 fetal chorionic vessel thrombosis,\n無血管末端絨毛梗塞 avascular terminal villi, fetal thrombotic vasculopathy, chorionic vascular thrombosis, \"fetal infarct\"：\n生理的には微小病変は15％の症例に認められる\n正常成熟絨毛2-6血管/villus,\n無血管絨毛占拠面積5%正常、30%生存、40-50%IUFD\n","絨毛壊死、線維化 stromal fibrosis、石灰化","生理的、fetal thrombotic vasculopathy, fetal artery thrombosis 陳旧梗塞","広範の場合意義あり：\nIUGR、母体胎児凝固異常、脳性麻痺、双胎間輸血、胎児仮死"]
[null,null,null,"出血","間質内出血 villous stromal hemorrhage\n\n\n","出血、ヘモジデリン（出血後24～48時間）\n","出血","分娩誘発、胎盤早期剥離、浮腫"]
[null,null,null,"線維化","正常<3%絨毛占拠",null,"fetal villous hypoperfusion/ischemia\n"]
[null,null,null,"合胞体結節 syncytial knot","正常 11-30%絨毛占拠, ","excess syncytial knot + accelerated aging + syncytial bridging between adjacent villi = protection against hypoperfusion","aging現象、fetal villous hypoperfusion/ischemia secondary to obliterative fetal stem artery\n\n","妊娠高血圧症候群、母体糖尿病、SLE,母体貧血、胎児還流低下、胎盤低酸素状態、早産時過成熟"]
[null,null,null,"cytotrophoblast","正常＜２０％占拠、扁平不明瞭化、\n２０％占拠＜明瞭→過形成\n","cytotrophoblastic proliferation","(maternal) uteroplacental hypoperfusion/ischemia"]
[null,null,null,"vasculosyncytial membrane, VSM\n","正常 20%絨毛占拠, 32W以降発生",null,null,"IUGR, stillbirth"]
[null,null,null,"基底膜肥厚","基底膜肥厚頻度３０％、\n正常<3%絨毛占拠","基底膜肥厚","(maternal) uteroplacental hypoperfusion/ischemia","糖尿病, IUGF, stillbirth, preeclampsia, hypertension, diabetes mellitus, Rh incompatibility\n"]
[null,null,null,"絨毛内線維素、fibrinoid necrosis of villi","正常：７月以降、 <3%絨毛占拠","類線維素沈着","生理的","糖尿病"]
[null,null,null,"凝固壊死・石灰沈着","凝固壊死・石灰沈着：8月以降は14-37%出現・生理的\n","凝固壊死・石灰沈着","生理的","満期産、異栄養性石灰化、"]
[null,null,null,"虚血","阻血型絨毛(顕微鏡所見のみでしか確認できないものに限定して）","未熟絨毛、絨毛血管腫様病変、合胞体結節、中隔嚢胞関連性中間型細胞性絨毛細胞（X細胞）増生、絨毛周囲類線維素\n","母体血流減少","臨床的意義無し、\n子宮内発育遅延、中毒症"]
[null,null,null,"壊死","類線維素壊死 intravillous fibrinoid, fibrinoid necrosis of villi：生理的に3％絨毛占拠に認められる\n","絨毛細胞直下基底膜から絨毛間質の類線維素沈着（胎盤病理では類線維素は抗体沈着を多分に意識して使用している）隣接絨毛のsyncytial knotと癒合しsyncytial bridgeを形成\n\n","絨毛細胞壊死脱落","胎盤血流不全、急性上行性感染時のエンドトキシンによる絨毛細胞の直接障害"]
[null,null,null,"空胞",null,"ST, Hofbauer","代謝障害"]
[null,null,null,"絨毛血管症 chorangiosis","hypervascularity:\nchorangiosis 7-9 vessels/villus",null,"hypoxia","IUFD, fetal hydrops, distress, neonatal thrombocytopenia in infarcted one, elevated AFP, 低酸素状態、母体糖尿病、周産期死亡、先天奇形、脳性麻痺"]
[null,null,null,"絨毛血管腫 chorangioma","hypervascularity:\nchorangioma 10</villus","Altshuler's criteria, 1984: chorangiosis: 10 vessels/villus in 10 villi in 10 non-infarcted areas at x100, chorangioma: hamartoma",null,"大型腫瘤：胎児心不全、胎児水腫、\n小型腫瘤：雨滴意義無し、\n多胎で増加"]
[null,null,"絨毛間\n母体血流異常","梗塞","梗塞infarct： \n頻度＜２５％、24-36W: 7.3%, 37-42W 6.5%, 42<: 0%\n辺縁部10％＜異常、\n絨毛占拠5％＜異常\nmultiple, central, 3cm<, 30%占拠＜、preterm：異常\n\n","intervillous space狭小化・消失\n中央部または１ｃｍ以上、15％＜は病的、\n割面が3角形状の凝集した凝固壊死絨毛塊で、赤色は発症数日以内で、白色は1週以上経過；　1.胎児面に底辺をもつ、2.母体面に底辺をもつ","1.胎児動脈血栓症：糖尿病、2.螺旋動脈硬化による母体血流途絶：中毒症","母体血管性疾患、中毒症, hypoxia, IUGR, periventricular leukomalacia, IUFD, maternal thrombophilic condition、糖尿病、SLE、胎盤機能不全"]
[null,null,null,"血栓","絨毛膜下血栓症 subchorionic thrombosis/hematoma","絨毛膜直下の血液プールで赤色、その後線維素によるlaminated thrombus、\n稀に羊膜腔に突出する腫瘤形成性の巨大絨毛膜下血腫（1cm≦Breus' mole）\n","fetal hemorrhage, eddying of maternal blood flow","重症な子宮内発育遅延、子宮内胎児死亡、Breus' mole seen also with missed abortion"]
[null,null,null,null,"絨毛間血栓 intervillous thrombus, intermvillous thrombohematoma：\n辺縁部傍基底層には1cm病変は生理的に10％の症例に認められる：臨床的意義は低い、\nfetal origin（病変内に有核赤血球が有る）>maternal origin (fetomaternal hemorrhage)\n","層状構造を示す血栓、\n分類：　\nA:部位：１：辺縁部傍基底層、２：中央部傍基底層、３：中央部または絨毛膜、\nB:大きさ：４：＜１ｃｍ、５：１ｃｍ＜、\nC:色調：６：赤色：数日以内(Kline's hemorrhage)、７：白色：1週以上経過","絨毛障害、母体血流異常+胎児血管出血","広範囲：意義あり：\n糖尿病、１・４：早産、２・５：子宮血流不全、３：絨毛母体間出血、腫大胎盤：赤芽球症、５：中毒症、子宮内発育不全"]
[null,null,null,"線維素沈着","絨毛膜下線維素沈着subchorionic fibrin (Langhans' stria)\n＜20%頻度\n1cm, 50%占拠＜異常\n\n","絨毛膜下における線維素沈着、減少または増加は病的","胎動に基づく母体血流異常・乱流","IUFD"]
[null,null,null,null,"１．絨毛周囲類線維素沈着 perivillous fibrin：＜２２％頻度\n5～10％の絨毛を囲繞は生理的、\n20-30%占拠<異常、\n\n２．絨毛間線維素沈着 intervillous fibrin deposit：妊娠後期に出現、\n絨毛占拠30％＜異常\n\n３．Transmural massive fibrin deposition, MFD (Katzman and Genest):\n全層、スライド50%占拠＜\n","２．絨毛周囲の線維素様沈着 perivillous fibrin depositの憎悪： intervillous expansion with fibrin, fuzzy border (cf. infarct: well circumscribed)、\n変性絨毛を囲繞するレース状絨毛周囲類線維素沈着、線維素内絨毛細胞増生","１．母体血流異常・乱流、在胎5月以降絨毛周囲に付着する線維素成分\n２．免疫性：lupus anticoagulant IgGと線維素沈着、凝固線溶系異常、lupus anticoagulant、母体血流異常・乱流","２．recurrent IUFD, immunological, low placental weight, periventricular leukomalacia if preterm、習慣性流早産, malaria"]
[null,null,null,null,"母体面梗塞 maternal floor perivillous fibrin deposit, socalled maternal floor infarct (misnomer), 母体床梗塞 maternal floor infarct、Gitter梗塞：\n厚さ3mm＜スライドガラスentire maternal floor （Ｋａｔｚｍａｎ　ａｎｄ　Ｇｅｎｅｓｔ, definition), 20-30%<\n\nRohr's stria; superficial fibrinoid of the basal plate （生理的)\n","凝固壊死絨毛を囲繞する線維素\nmassive perivillous fibrin deposit in basal plate: 3cm<, 40%<","生理的、高度：免疫性","妊娠中期の習慣性早産、通常母体血管性疾患は認められない immunologic etiology, IUFD, IUGR, preterm, neurologic impairment in preterm"]
[null,null,null,"炎症","chronic intervillositis, massive chronic intervillositis","絨毛間：瀰漫性組織球浸潤CD68+, fibrinoid deposit, atherosis, CAM, chronic villitis, malaria\n","maternal immune reaction to fetal tissue?\n","recurrent abortion, diabetes, PIH, drug abuse, SLE IgM deposit, IUGR"]
[null,null,"血管","生理的変化の欠如","生理的螺旋動脈壁の変化の消失、脱落膜血管症と合併","動脈内中膜への絨毛細胞浸潤と好酸化による内腔の拡張が認められない\n","高血圧、lupus anticoagulant、中毒症","中毒症、子宮内発育不全、死産、早産、胎盤剥離"]
[null,null,"母体疾患","癌転移"]
["中隔",null,"septum","septal cyst","８月以降：正常、意義不明\n","septal cyst","unclear, X cell proliferation","distress"]
["胎盤母体面：境界部","胎盤基底層","出血",null,"後血腫： \n後胎盤 retroplacental hematoma/hemorrhage, 胎盤早期剥離,\n30%占拠<異常、\n\n","脱落膜血管よりの出血、強固に胎盤母体面に付着","脱落膜血管異常、コカイン、喫煙、外傷、急速遂娩、絨毛羊膜炎","胎児仮死、失血、早産、上行感染、DIC, HELLP"]
[null,null,null,null,"辺縁出血 marginal hematoma","辺縁部に半月状に存在","母体出血","臨床的意義服ない"]
[null,null,null,null,"卵膜外 retromembranous"]
[null,null,"実質血管 decidual vasculopathy/vascular pathology\n","硬化","脱落膜血管症、生理的螺旋動脈壁の変化$の消失と合併 incomplete  or absent physiologic conversion","acute atherosis：\n抗体と補体を含むフィブリノイド壊死 fibrinoid necrosis/atherosis、脂肪含有組織球 foamy macrophage, lipophage (atherosis)、血管周囲単核球浸潤、狭窄、血栓\n","高血圧、lupus anticoagulant、中毒症","中毒症、抗リン脂質抗体症候群、SLE、IUGR血流減少による子宮内発育遅延、子宮内胎児死亡、早産, abruption"]
[null,"子宮内膜：胎盤床",null,"血管炎","脱落膜血管炎 decidual vasculitis：生理的に5％の症例に認められる\n血管狭窄50-70%<異常\n","血管壁内リンパ球浸潤、鑑別：生理的に認められる血管周囲リンパ球囲繞","生理的、免疫性","自己免疫性、中毒症、抗リン脂質抗体症候群、SLE、IUGR血流減少による子宮内発育遅延、"]
[null,null,null,null,"急性血管炎 acute vasculitis","顆粒球浸潤、壊死性脱落膜炎\n","急性上行性感染"]
[null,null,null,"血栓","脱落膜血栓 decidual thrombus：生理的に微小血栓は認められる\n","血栓","生理的、免疫性","自己免疫性"]
[null,null,"間質","炎症","絨毛脱落膜羊膜炎 chorioamnionitis","化膿性壊死性脱落膜炎、化膿j性羊膜炎\n","急性上行性感染"]
[null,null,null,null,"形質細胞浸潤 decidual plasma cells","付着絨毛・生理的変化の脈管周囲の形質細胞浸潤\n","免疫性","Rh不適合妊娠、ウイルス感染、死産"]
[null,null,null,"線維素沈着","uteroplacental fibrinoid of the basal plate, deep fibrinoid of the basal plate (Nitabuch's stria)\n","間質への層状の線維素沈着　厚さ100μm","(正常の）移植免疫性"]
[null,null,"$ physiological funnelled-dilatation of spinal artery in decidua basalis:"]
[null,null,null,"destruction of elastic and muscle layers with IT infiltration and fibrinoid change"]

{"sheet":"低酸素","index":1,"n_rows":50,"n_cols":8,"rows_kept":50,"cut":false,"hidden":false,"merged":[]}
["低酸素状態"]
[null,null,"急性","慢性",null,null,"胎児仮死","FGR"]
[null,null,null,"preuterine","uterine","postuterine"]
["絨毛","成熟中間絨毛から終末絨毛への分岐、\n絨毛形",null,null,null,"絨毛分岐不良・絨毛密度減少％、直径減少"]
[null,"成熟度",null,"均一！","過成熟”"]
[null,"vascularity",null,"chorangiosis＃","branching angiogenesis”","hypovascularity&"]
[null,"細胞外基質",null,"減少（明調）",null,"硬化、線維化"]
[null,"絨毛間質Hofbauer組織球",null,"増加"]
[null,"cytotrophoblast"]
[null,"syncytial knot",null,"非apoptotic 増加","非apoptotic 増加","減少、apoptotic散在"]
[null,"胎児赤芽球",null,null,null,null,"＊"]
["梗塞","villous agglutination","+",null,"+"]
["basal plate","placental site giant cells",null,null,"+"]
[null,"筋型血管",null,null,"+"]
[null,"螺旋動脈atherosis;",null,null,"+"]
[null,"中間型trophoblast増加",null,null,"+"]
["卵膜","層状壊死","+"]
[null,"被包脱落膜の血管壁肥厚＄",null,null,"+"]
[null,"胎便: free pigment, Mφ貪食@",null,null,null,null,"+"]
["重量","小胎盤、低重量胎盤",null,null,null,null,null,"+"]
["臍帯","細い≦8mm",null,null,null,null,null,"+"]
[]
["preuterine","母体貧血、高地、チアノーゼ疾患"]
["uterine","子宮胎盤血流不全 utero-placental underperfusion"]
[null,"妊娠高血圧症候群 pregnancy-induced hypertension (PIH)"]
[null,"晩発性fetal growth retadation (FGR)"]
[null,"SLE"]
[null,"抗リン脂質抗体症候群"]
["postuterine","絨毛間腔から酸素を摂取できない絨毛異常"]
[null,"臍帯動脈の血流速度波形上、拡張期に血流の途絶/逆流"]
[null,"高度のFGR"]
[]
["！","cotyledon中央は酸素濃度が高く成熟が遅れ、辺縁は酸素濃度が低いので"]
[null,"成熟が進む。生理的には成熟度が不均衡である。"]
["”","血管数が7-9個に増加した成熟終末絨毛が増加 villous hypermaturity"]
["＃","血管数が10個以上に増加した成熟終末絨毛が増加"]
["＄","血管壁が血管直径の1/3超え"]
["％","terminal villous deficiency, distal villous hypoplasia"]
["&","fetal thrombotic vasculopathy"]
[null,"子宮内胎児死亡子宮内残留"]
[null,"胎児血流停滞"]
["＊","妊娠第3期に複数の有核赤血球の出現は異常"]
[null,"胎児仮死発生2－3時間後にerythropoietin分泌、半日で有核赤血球が出現"]
[null,"胎児虚血、感染、胎児貧血、胎児急性失血"]
[";","decidual vasculopathy"]
["@","meconium-staining"]
[null,"DD. 血鉄素hemosiderinは屈折性、胎便色素は非屈折性"]
[null,"DD. 肉眼上、CAM"]
[]
["参照","藤林真理子他．Hypoxia（低酸素状態）における胎盤病変．病と臨 2014;32:511-7."]

{"sheet":"母体疾患1","index":2,"n_rows":10,"n_cols":9,"rows_kept":10,"cut":false,"hidden":false,"merged":[[5,0,9,0],[2,0,2,1]]}
["母体疾患と胎盤病理組織"]
[]
["所見/疾患",null,"正常妊娠","妊娠遷延","早産","RH不適合","糖尿病","高血圧","中毒症"]
["母血流","梗塞","+/-","+/-","+/-","+/-","+","++","++"]
["児血流","血栓、胎児動脈","+/-","+","+/-","+/-","++","+/-","+/-"]
["絨毛","フィブリノイド壊死","+/-","-","++","++","++","+/-","+/-"]
[null,"未熟","+/-","+/-","+/-","++","++","+/-","+/-"]
[null,"老化senescence","+/-","++","+/-","+/-","+/-","+/-","+/-"]
[null,"基底膜肥厚","+/-","+","+/-","+/-","+","++","+++"]
[null,"線維化","+/-","+++","+/-","+/-","++","+/-","+/-"]

{"sheet":"母体疾患2","index":3,"n_rows":50,"n_cols":4,"rows_kept":50,"cut":false,"hidden":false,"merged":[[4,3,5,3],[39,1,39,2],[4,0,5,0],[4,1,5,1],[17,1,17,2],[18,1,18,2],[19,1,19,2],[22,1,22,2],[23,1,23,2],[24,1,24,2],[20,0,21,0],[38,1,38,2],[41,1,41,2],[15,1,15,2],[16,1,16,2],[28,1,28,2],[29,1,29,2],[30,1,30,2],[31,1,31,2],[32,1,32,2],[33,1,33,2],[34,1,34,2],[25,1,25,2],[20,1,21,2],[40,1,40,2],[35,1,35,2],[36,1,36,2],[37,1,37,2]]}
["母体疾患と胎盤所見"]
["disorder","macro","micro","comment"]
["toxemia","low weight,\ninfarct: 5%<,\nretroplacental hematoma","villi: accelerated matureation,  CT hyperplasia, thick BM,\nm artery: acute atherosis,\nthrombosis\n","HELLP syndrome: severe lesion"]
["hypertension","low weight,\ninfarct: 5%<,\nretroplacental hematoma","villi: same as toxemia, less syncytial knots,\nm artery: intimal hyperplasia, medial thickening\n","complicated with toxemia findings"]
["diabetes","increased weight, placentomegaly, increased intervillous space, increased villous tissue\npaler,\nsingle umbilical artery,\nlocally pale: fetal artery thrombosis\n","increased intervillous space, increased villous tissue, edema, variable maturity (delayed, normal, accelerated), \nnumerous tortuous vessels, \nobliterative endarteritis, \nthrombosis of fetal stem artery\n","preeclampsia, late fetal death, congenital anomaly, fetal macrosomia, neonatal hypoglycemia, fetal asphyxia, fetal trauma, dystocia難産/abnormal labor due to large fetus"]
[null,null,"fetal vasculopathy developed with maternal vasculopathy"]
["abortion","torsion, stricuture, true knot of cord,\nmassive subchorial thrombosis,\npartial mole,\nmaternal floor infarct\n","villi: stromal fibrosis withprominet trophoblast,\nhydropic change with hypo- or avascularity of villi,\npartial mole,\nhypoplastic villi\n","hydropic: genetic analysis required"]
["premature labor","like:\nabruptio, preeclampsia, hypertension, diabetes, CAM","villi: edema, variable maturity (delayed, normal, accelerated),\nfibrinoid necrosis","normal for gestational age"]
["postmaturity","heavy, infarct, calcification","villi: stromal fibrosis, prominent trophoblast, thick BM, obliterative endarteritis of fetal stem artery, hypoascular\n","calcification"]
["polyhydramnios 2L<","fetal malformation: esophageal atres, TTTS, diabetes, chorioangioma\n","*","*"]
["PROM","retroplacental hematoma","acute CAM","culture"]
["maternal fever","*","CAM, villitis, funisitis"]
["abuse","low weight, retroplacental hematoma, PROM, meconium staining\n","CAM, villitis, hypovascularity of villi, stromal fibrosis","alcohol, tobacco, cocaine, heroin"]
["abruptio placentae","retroplacental hematoma and overlying infarction","preeclampsia, hypertension","retroplacental hematoma in 30% of abruptio, lost arteficially or as vaginal bleeding, result in depressed maternal surface\n"]
["SLE","infarct 25%<, retroplacental hematoma","acceleration  of villi, acute atherosis, obliteration of fetal stem artery","lupus anticoagulant without SLE: acute athrosis with thrombosis,\npreeclampsia superimposed on SLE: vascular lesion\n"]
["carcinoma, cervix","*",null,"invasion, 1 trimester conization: 15-30% spontaneous loss, vaginal delivery: no spread\n"]
["carcinoma, advanced, metastatic","intervillous metastases: melanoma, breast, oat cell ca.",null,"maternal-fetal metastasis: rare"]
["carcinoma, chemotherapy","*",null,"abortion, anomaly: no increase"]
["leiomyoma","myofibers within the delivered basal plate, \nabnormal shape, extra lobes, abnormally thin, fenestrated placenta, \nlow-lyng or preia, \naccreta, abruption\n\n",null,"mild uterine vascular insufficiency: poor pericervical perfusion, "]
["trauma, abdominal","triphoblastic basophilia by maternal hypoperfusion,\nabruption or small abruption-like lesion in preterm labor or birth after trauma\n\n",null,"fetal demise up to 20% in severe cases,\nmaternal and fetal hypoxemia,\nabruption in 6-66%, premature delivery, PROM, fetal fractures\n"]
["thyroid","*",null,"if untreated: hypothyroidism, infertility, increased abortion, congenital anomaly, stillbirth"]
[null,null,null,"hypothyroidism, IUGR, fetal tachycardia, hyperkinesis, neonatal thyrotoxicosis\n"]
["skin, melanosis","melanin deposit in Hofbauer cell, calcification",null,"dermatopathic melanosis"]
["asthma",":*",null,"prematurity, peinatal death, transplacental theophylline: fetal tachycardia, epinephrine: decreased uteroplacental flow and congenital anomaly\n "]
["sickle cell, hemoglobinopathy","intervillous sickling, acceleration of villous maturity, infarct, abruption, villous edema",null,"IUGR, abortion"]
["anemia","placentomegaly, increased syncytial knotting",null,"folic acid deficiency: abruption, nonimmune hydrops fetalis\n"]
[]
[]
["inflammatory bowel disease","*",null,"*"]
["obesity","placentomegaly, delayed villous maturation",null,"excessive fetal growth, increased risk of diabetes mellitus, preeclampsia, medical complications: wound dehiscence, thrombophlebitis, dystocia, dysfunctional labor, fetal trauma, twins\n"]
["renal disease, transplantaton","vasculopathy due to renal failure",null,"infertility, preeclmapsia, infection"]
["liver disease","HELLP syndrome: liver dysfunction, preeclampsia",null,"HELLP syndrome, acute fatty liver in 3rd trimester, jaundice, hepatic encephalopathy, maternal and fetal mortality\n"]
["heart disease","villous hypoperfusion, fibrosis, intervillous thrombosis, reduced villous surface exchange",null,"reduced uteroplacental blood flow, IUGR\n"]
["alcohol","socioeconomic abuse: acute ascending infection, meconium staining\n",null,"IUGR, mental retardation, dysmorphism, short umbilical cord\n"]
["cocaine","maternal vasoconstriction: retroplacental hematoma, meconium\n",null,"abruptio placenta, IUGR, neonatal hypetension, learning disability\n"]
["hypercoagulability","decidual thrombi, placental infarction, chronic villitis",null,"systemic arterial or venous thrombi, pregnancy wastage\n"]
["connective tissue disorder","chronic villitis, preeclampsia, scleroderma: maternal floor infarct",null,"SLE: fetal arrhthmia due to cardiac conduction system damage, scleroderma: abortion, stillbirth, prematurity\n"]
["tabacco abuse","reduced placental weight, fibrosis/hypovascularity or hypervascularity, decidual necrosis, small infarct, degeneration of endothelium with thrombosis of umbilical vessels\n",null,"abortion, IUGR, single umbilical artery, passive smoking may have similar effects\n"]
["ITP","intervilous thrombosis, infarct, deidual vascular lesion",null,"intraventricular hemorrhage of neonate 50%\n"]
["TTP","hyaline thrombi in maternal dcidual vessels resembling atheroma\n",null,"high mortality: maternal and fetal\n"]
[]
[]
["acute atherosis","fibrinoid necrosis, lipid macrophage"]
["CAM","chorioamnionitis"]
["CT","cytotrophoblast"]
["m","maternal"]
["PROM","premature, preterm and prolonged rupture of membranes"]
["TTTS","twin to twin transfusion syndrome"]
[]
["Joshi VV. Handbook of placental pathology. IGAKU-HOIN, 1994. pp.85-7."]

{"sheet":"児疾患","index":4,"n_rows":42,"n_cols":4,"rows_kept":42,"cut":false,"hidden":false,"merged":[[2,0,5,0],[2,2,5,2],[6,2,9,2],[6,0,9,0],[17,0,18,0],[17,2,18,2],[7,3,9,3],[10,0,14,0],[10,2,14,2],[12,3,14,3],[26,0,27,0],[26,1,27,1],[26,2,27,2],[15,2,16,2],[15,0,16,0],[19,2,21,2],[19,1,21,1],[19,0,21,0],[34,0,36,0],[35,1,36,1],[34,2,36,2],[28,0,29,0],[28,2,29,2],[28,3,29,3],[31,0,33,0],[31,1,33,1],[31,2,33,2],[22,0,25,0],[22,2,25,2],[24,3,25,3]]}
["児疾患と胎盤所見"]
["disorder","macro","micro","comment"]
["twin, \nMoDi","single placental disc, two amniotic sacs, of same or dissimilar size, and dividing septum attached to the feta lsurface are seen; \n","diving septum is composed of two amnions only, without intervening chorion","superficial vascular nastomoses can be visualized by naked eye examination;"]
[null,"velamentous or marginal insertion and a single umbililical artery are more frequnet; vascular anastomoses are present in 85-100% of cases; \n",null,"injection studies may be done to confirm these fings;"]
[null,"pallor of the donor and congestion of the recipient territory are seen when three is twin transfusion syndrome;\n ",null,"injection studies are the only way to demonstrate deeper arteriovenous anastomoses via a shared lobule;"]
[null,"amnion nodosum may be present in the donor territory",null,"the twin transfusion syndrome is seen in 15-30% of twins with MoDi placenta\n"]
["twin, \nDiDi","two placnetal discs mya be completerly separated or fused, resumebling the MoDi placenta;\n","dividing septum shows chorion between the two amnios","twin transfusion is extremely rare;"]
[null,"the fusion may be partial, with fusion of membranes, only or an intervening portion of the membranes between the two disks may be present;\n",null,"the pathology of separate DiDi placentas is same as that of singleton placenta"]
[null,"a dividing septum is present in fused placentas;\n"]
[null,"vasular anastomoses are extremely rare\n"]
["twin, \nMoMo","only one amniotic sac and a single placental disk without a dividing septum are present;\n","no specific features","demonstration of vascular anastomoses should be done when twin transfusion syndrome is present-"]
[null,"a small amniotic fold representing disrupted septum of a previously DiDi placental may be present;\n",null,"this is the rarest type of twin placenta;"]
[null,"vascular anastomoses are uncommon;\n",null,"a high incidence of fetal morbidity and mortality is present"]
[null,"findings of twin transfusion syndrome described above may be seen;\n"]
[null,"the cords may be entagled\n"]
["twin, \nvanishing twin","plaques of perivillous fibrin, embryonic remnants on the membranes, and a second amniotic sac, with or without an embryo, may be found;\n","embryonic remnant shows autolyzed embryonic tissues","embryonic remants;"]
[null,"the embryonic remnant appears as a flattened yellow plaque, with or without occular pigment\n",null,"twin may be lost via vaginal bleeding"]
["twin, \nfetus papyraceous/\nfetus compressus, \nFP/FC","FP/FC representing a dead twin is identifiable as a plaque of dehydrated remnent, with or without identifiable fetal parts;\n","autolyzed feta tissues are seen in the sections from FP/FC","rentogenograms may be taken to show the skeleton of FP/FC;"]
[null,"umbilical cord torsion or massive infarction may cause fetal death\n",null,"the cause of fetal death may not be evident"]
["twin, \nacardiac twin","MoMo placenta with artery-to-artery and vein-to-vein anastomoses between the viable twin and acardica twin placental territories","no specific features","vascular anastomosed should be looked for;"]
[null,null,null,"the acardiac twin has no heart or a severely malformed heart;"]
[null,null,null,"other malformations may also be present"]
["IUGR;\nintrauterine fetal growth retardation","associated with maternal factors (preeclampsia, chronic renal disease, substance abuse, etc), \n","histologic findings related to fetal, maternal, and placental factors are seen","the placenta is small, which is a reflection than a cause of IUGR;"]
[null,"fetal factors (congenital anomalies, chromosomal disorders, intrauteirne infarction, etc),\n",null,"the cause of IUGR may not be evident,"]
[null,"and placental factors (extracorial placenta, velamentous insertion of cord, maternal floor infarction, VUE, extensive infarction or perivillous fibrin depostion, etc.);\n",null,"and the placenta may be normal except for its size"]
[null,"placenta findings related to the maternal, fetal, and placental factores are seen\n"]
["thrombi","enlarged weight and size, pallor, intervillous  thrombi","villi: immature with persistent CT, numerous normoblasts in capillaries, villous edema, hemosiderin in chorionic macrophages\n\n","severity of placental changes is related to severity of fetal anemia;\n"]
[null,null,null,"the fetus is hydropic"]
["nonimmunologic hydrop fetalis, \nNIHF","causes: genetic and metabolic disorders, chromosomal abnormalities, cardiac and pulmonary anomalies, thalassemia, fetaomaternal hemorrhage, fetal infection, fetal tumors, arrhthmias, congenital nephrotic syndrome;\n","associated conditions","22%: no associated conditions"]
[null,"placental findings related to the disorders are present\n"]
["chromosomal disorders, \ntrisomy 13, 18, 21","samall placental, high incidence of single umbilical artery\n","villi: delayed maturation, hypovascularity, large, atypical Hofbauer or trophoblastic cells","karyotyping should be done on the chorion or amnion"]
["metabolic disorders","large hydropic placenta","vacuoles in ST, IT, Hofbauer cell, endothelim and fetal WBC in villous capillary","vacuoles represent the accumulated metabolite, which is dissolved during processing:\n"]
[null,null,null,"EM may give clues regarding the precise disagnosis (eg. Niemann-Pick disease, glycogenosis type IV);\n"]
[null,null,null,"biochemical study of snap-frozen fresh placental tissue is essential for definitive demonstration of enzyme deficiency\n"]
["IUFD;\nintrauterine fetal death","massive infarction, retroplacental hematoma, large chorangioma, true knot, torsion or stricture of cord, nuchal cord, intrauterine infection,\n","assessment of the interval between IUFD and delivery can be made on the basis of histologic findings","maternal conditions (eg. Preeclampsia), fetal ones (eg. Erythroblastosis fetalis) may also cause IUFD;"]
[null,"maternal floor infarction, and extensive perivillous fibrin deposition are placental lesions that may lead to IUFD",null,"certain placental abnormalities such as stromal fibrosis, hypovascularity, thrombosis of vessels in stem villi, and villous edema are secondary to IUFD;\n"]
[null,null,null,"confined placental mosaicism may occur in rare cases\n"]
[]
["DiDi: Di-chorionic Di-amniotic"]
["MoDi: Mono-chorionic Di-amniotic"]
[]
["Joshi VV. Handbook of placental pathology. IGAKU-HOIN, 1994. pp.93-7."]

{"sheet":"新生児分類","index":5,"n_rows":27,"n_cols":2,"rows_kept":27,"cut":false,"hidden":false,"merged":[]}
[]
["新生児期"]
["　生まれた日を０として２７日目までのの時期"]
[]
["周産期"]
["　妊娠２８週以後の胎児期と　生まれてから７日目までの期間"]
[]
["在胎週数による分類"]
[null,"早期産児　　　　　　在胎３７週未満で生まれた赤ちゃん"]
[null,"正期産児　　　　　 在胎３７週以上　４２週未満で生まれた赤ちゃん"]
[null,"過期産児　　　　　 在胎４２週以上で生まれた赤"]
[]
["在胎週数と出生体重の関係による分類"]
[null,"small-for-dates (light-for-dates) 　　在胎週数に対して出生体重が軽い（子宮内胎児発育遅延）　　"]
[null,"appropriate-for-dates 　　　　　在胎週数にあった出生体重（出生体重基準値の１０～９０パーセンタイル）"]
[null,"large-for-dates (heavy-for-dates) 　在胎週数に対して出生体重が重い場合　　"]
[]
["生まれたときの体重による分類"]
[null,"超低出生体重児 　　１０００g未満で生まれた赤ちゃん"]
[null,"極低出生体重児　　 １５００ｇ未満で生まれた赤ちゃん"]
[null,"低出生体重児 　　　 ２５００g未満で生まれた赤ちゃん"]
[null,"巨大児 　 　　 　 　 ４０００ｇ以上で生まれた赤ちゃん"]
[]
["成熟度による分類"]
[null,"未熟児　　　　　　　２５００ｇ以下で生まれた赤ちゃんや　早期産の赤ちゃん"]
[null,"成熟児　　　　　　　正期産・正常体重でうまれた赤ちゃん　　お母さんのお腹の外の環境に適応できる"]
[null,"過熟児　　　　　　　過期産児　や　巨大児　"]

{"sheet":"胎盤重量、単胎","index":6,"n_rows":40,"n_cols":13,"rows_kept":40,"cut":false,"hidden":false,"merged":[]}
[null,"胎盤重量"]
[null,"在胎週数","平均値ｍ",0.95]
[null,8,1.6,0,3.7]
[null,9,15.2,13.3,17]
[null,10,28.8,27.2,30.4]
[null,11,42.4,41.1,43.8]
[null,12,56.1,54.8,57.3]
[null,13,69.7,68.400000000000006,71]
[null,14,83.3,81.8,84.8]
[null,15,96.9,95.2,98.6]
[null,16,110.5,108.5,112.5]
[null,17,124.2,121.8,126.5]
[null,18,137.80000000000001,135,140.5]
[null,"Kalousek DK et al. Pathology of the human embryo and previable fetus. Springer, new York, 1990;228."]
[]
[]
[]
[null,"在胎週数","平均値ｍ","標準偏差σ",0.03,0.05,0.1,0.25,0.5,0.75,0.9,0.95,0.97]
[null,"22週",189,89,null,99,107,130,166,206,265,499]
[null,"23週",190,41,null,null,127,142,158,230,262]
[null,"24週",190,42,null,null,128,157,192,232,252]
[null,"25週",197,70,null,106,128,153,194,236,299,400]
[null,"26週",226,100,null,107,138,179,200,259,281,370]
[null,"27週",240,77,null,119,130,166,242,310,332,383]
[null,"28週",223,66,103,128,140,173,214,261,321,348,371]
[null,"29週",269,96,124,135,161,214,252,309,352,496,629]
[null,"30週",324,88,135,150,208,269,316,374,433,502,570]
[null,"31週",314,105,142,152,175,245,313,360,417,479,579]
[null,"32週",325,77,161,214,241,273,318,377,436,461,468]
[null,"33週",351,83,190,224,252,286,352,413,446,475,504]
[null,"34週",381,84,221,260,283,322,382,430,479,527,558]
[null,"35週",411,99,232,280,291,349,401,471,544,600,626]
[null,"36週",447,110,270,291,320,369,440,508,586,628,679]
[null,"37週",467,107,303,324,349,390,452,531,607,660,692]
[null,"38週",493,103,320,335,365,420,584,500,629,675,706]
[null,"39週",500,103,330,350,379,426,493,564,635,683,723]
[null,"40週",510,100,340,360,390,440,501,572,643,685,715]
[null,"41週",524,100,358,379,403,452,515,583,655,705,738]
[null,"42週",532,90,370,388,412,460,525,592,658,700,771]
[null,"胎盤重量、Frederic TK et al. Placental pathology, AFIP"]

{"sheet":"FP比","index":7,"n_rows":24,"n_cols":12,"rows_kept":24,"cut":false,"hidden":false,"merged":[]}
["胎児/胎盤重量比"]
["在胎週数","m","sd",3,5,10,25,50,75,90,95,97]
[22,2.9,0.8,null,1,1,2,2.4,3.6,3.9,4.3]
[23,3.3,0.7,null,null,null,2.4,2.9,3.6,4.5]
[24,3.4,1,null,null,null,2,2.6,4,4.5999999999999996]
[25,4,1.4,null,1.7,2.2999999999999998,3.2,3.8,4.5999999999999996,6,7.4]
[26,4.0999999999999996,1.2,null,2.1,2.8,3.4,3.7,4.8,5.2,7.7]
[27,4.5,1.1000000000000001,null,2.6,3,3.3,3.6,4.5,6,7.1]
[28,4.8,1,2.2999999999999998,2.5,3.6,3.9,4.2,4.7,6.5,6.6,6.9]
[29,5.2,1.4,1.9,2.5,3.7,4.4000000000000004,5,5.7,7.5,8,9.1999999999999993]
[30,5.2,1.1000000000000001,2.7,3.1,3.6,4.5,5.0999999999999996,5.8,6.8,6.9,7.6]
[31,5.5,1.1000000000000001,3.3,4.0999999999999996,4.4000000000000004,4.7,5.4,6.2,6.9,7.3,8.1999999999999993]
[32,5.9,1.2,3.2,4.0999999999999996,4.4000000000000004,5,5.8,6.8,7.7,7.9,8.4]
[33,6,1.1000000000000001,4.3,4.5,4.7,5.2,6,6.6,7.7,8.1999999999999993,8.6999999999999993]
[34,6.2,1,4.4000000000000004,4.7,5,5.5,6.1,6.7,7.5,7.9,8.1999999999999993]
[35,6.4,1.2,4.5,4.7,5,5.6,6.3,7.2,8,8.6,9.1]
[36,6.6,1.1000000000000001,4.8,4.9000000000000004,5.3,5.8,6.4,7.3,8.1,8.4,8.8000000000000007]
[37,6.8,1.1000000000000001,4.9000000000000004,5.0999999999999996,5.4,6,6.7,7.4,8.1999999999999993,8.8000000000000007,9.1]
[38,6.9,1.1000000000000001,5.0999999999999996,5.2,5.6,6.1,6.8,7.5,8.3000000000000007,8.9,9.1999999999999993]
[39,7.1,1.1000000000000001,5.2,5.4,5.7,6.3,7,7.7,8.5,9.1,9.4]
[40,7.2,1.1000000000000001,5.3,5.5,5.8,6.4,7.1,7.9,8.6,9.1,9.5]
[41,7.2,1.1000000000000001,5.4,5.6,5.9,6.5,7.1,7.8,8.6,9.1,9.4]
[42,7.1,1.1000000000000001,5.3,5.5,5.9,6.4,7.1,7.8,8.5,8.9,9.1]
["AFIP Atlas of nontumor pathology, placenta, 2004"]

{"sheet":"胎盤重量、双胎","index":8,"n_rows":26,"n_cols":6,"rows_kept":26,"cut":false,"hidden":false,"merged":[]}
["胎盤重量、双胎"]
["在胎週数",0.1,0.25,0.5,0.75,0.9]
[19,161,185,212,239,263]
[20,166,190,218,245,270]
[21,176,202,231,260,286]
[22,191,219,251,282,310]
[23,210,241,276,311,343]
[24,232,267,307,346,382]
[25,257,297,341,386,426]
[26,284,330,380,430,475]
[27,314,365,421,478,528]
[28,345,401,464,527,584]
[29,377,439,509,579,641]
[30,409,478,554,631,700]
[31,441,516,600,683,758]
[32,472,554,644,734,815]
[33,503,590,687,783,870]
[34,531,624,727,830,923]
[35,558,656,764,873,971]
[36,582,684,798,912,1014]
[37,602,708,827,945,1051]
[38,619,728,850,972,1082]
[39,631,743,868,993,1105]
[40,639,753,879,1005,1118]
[41,642,756,882,1009,1123]
["Pinar H et al. Reference values for sigleton and twin placental weights. Pediatr Pathol Lab Med 1996;16904."]

{"sheet":"臍帯","index":9,"n_rows":69,"n_cols":4,"rows_kept":69,"cut":false,"hidden":false,"merged":[]}
["臍帯長"]
["在胎週数","m (cm)",0.05,0.95]
[8,6.4,5.2,7.7]
[9,8,7,9.1]
[10,9.6999999999999993,8.6999999999999993,10.6]
[11,11.3,10.5,12.1]
[12,12.9,12.2,13.6]
[13,14.5,13.9,15.1]
[14,16.100000000000001,15.5,16.7]
[15,17.7,17.100000000000001,18.399999999999999]
[16,19.399999999999999,18.600000000000001,20.100000000000001]
[17,21,20.5,21.4]
[18,22.6,21.5,23.7]
["Ｋａｌｏｕｓｅｋ　ＤＫ et al. Pathology of the human embryo and previable fetus, s"]
["pirnger, New York, 1990;228."]
[]
["在胎週数","m (cm)","±"]
[20,32.4,8.6]
[22,36.4,9]
[24,40.1,10.1]
[26,42.5,11.3]
[28,45,9.6999999999999993]
[30,47.6,11.3]
[32,50.2,12.1]
[34,52.5,11.2]
[36,55.6,12.6]
[38,57.4,12.6]
[40,59.6,12.6]
[42,60.3,12.7]
[44,60.4,12.7]
[46,60.5,13]
["Naeye RL. Umbilical cord length. clinical significance. J Pediatr 1985;107:278-81."]
[]
[]
[]
["臍帯太さ"]
["在胎週数","m (mm)","sd (mm)"]
[10,3.19,0.4]
[11,3.65,0.41]
[12,3.68,0.53]
[13,4.37,0.43]
[14,5.0999999999999996,0.39]
[15,5.95,0.73]
[16,6.47,0.81]
[17,7.23,0.79]
[18,7.87,0.74]
[19,8.68,1.07]
[20,9.4700000000000006,1.48]
[21,10.73,1.55]
[22,10.93,1.58]
[23,12.23,1.62]
[24,13.14,1.72]
[25,13.44,1.74]
[26,14.34,1.8]
[27,14.06,1.99]
[28,14.34,2.0699999999999998]
[29,16.25,2.0099999999999998]
[30,16.239999999999998,2.12]
[31,16.45,2.21]
[32,16.59,2.42]
[33,16.72,2.4900000000000002]
[34,16.72,2.57]
[35,16.27,2.67]
[36,16.53,2.2999999999999998]
[37,16.010000000000002,1.99]
[38,15.85,1.82]
[39,14.48,1.6]
[40,15.59,1.41]
[41,14.42,1.5]

{"sheet":"羊水量AFI","index":10,"n_rows":21,"n_cols":7,"rows_kept":21,"cut":false,"hidden":false,"merged":[]}
["羊水量 amniotic fluid index, AFI"]
[null,"AFI, sum (mm)",null,null,null,null,"羊水量"]
["在胎週数",2.5000000000000001E-2,5,50,95,97.5,"(ml)"]
[28,96,97,140,199,214,800]
[29,93,95,137,195,208]
[30,91,94,135,190,202]
[31,88,92,132,185,196]
[32,86,91,130,180,189]
[33,83,90,128,175,183]
[34,81,88,125,170,177]
[35,78,87,123,166,171]
[36,76,85,120,161,165]
[37,74,84,118,156,159]
[38,71,83,116,151,153]
[39,69,81,113,146,147]
[40,66,80,111,141,140]
[41,64,79,109,137,134]
[42,61,77,106,132,128,400]
[]
["Hinh ND et al. Amniotic fluid index measurements in normal pregnancy after after 28 gestational weeks."]
["Int J Gynecol Obstet 2005;91:132-6."]

{"sheet":"IUFD分娩経過時間","index":11,"n_rows":26,"n_cols":4,"rows_kept":26,"cut":false,"hidden":false,"merged":[[1,0,10,0],[11,0,15,0],[16,0,21,0]]}
["胎内死亡時・分娩間の経過時間の推定"]
["確実な所見","腎尿細管","核好塩基性消失","４ｈ"]
[null,"肝","核好塩基性消失","２４ｈ"]
[null,"心筋内側1/2","核好塩基性消失","２４ｈ"]
[null,"心筋外側1/2","核好塩基性消失","４８ｈ"]
[null,"気管支粘膜","核好塩基性消失","９６ｈ"]
[null,"肝","核好塩基性消失最大限","９６ｈ"]
[null,"消化管","核好塩基性消失最大限","１Ｗ"]
[null,"副腎","核好塩基性消失最大限","１Ｗ"]
[null,"気管軟骨","核好塩基性消失","１Ｗ"]
[null,"腎","核好塩基性消失最大限","４Ｗ"]
["やや確実な所見","消化管","核好塩基性消失","８ｈ"]
[null,"副腎皮質","核好塩基性消失","２４ｈ"]
[null,"膵","核好塩基性消失最大限","３６ｈ"]
[null,"消化管全層性","核好塩基性消失","７２ｈ"]
[null,"肺胞壁","核好塩基性消失","２Ｗ"]
["不確実な所見","気管支粘膜","剥離","１８ｈ"]
[null,"気管支軟骨基質","好塩基性消失","２４ｈ"]
[null,"胸腺皮質リンパ球","核破砕","２４ｈ"]
[null,"胸腺皮質リンパ球","核好塩基性消失","４８ｈ"]
[null,"腎糸球体","核好塩基性消失","４８ｈ"]
[null,"副腎成人皮質","核好塩基性消失","７２ｈ"]
[]
["Genest DR et al. Estimating the time of death in stillborn fetuses: I. Histologic"]
["evaluation of fetal organs: an autopsy study of 150 stillborns. Obstet Gynecol"]
["80;581:1992."]

{"sheet":"妊娠早期流産物GD","index":12,"n_rows":37,"n_cols":9,"rows_kept":37,"cut":false,"hidden":false,"merged":[[13,0,13,3],[34,0,34,3]]}
["conceptus with growth disorganization"]
[]
["GD1: empty sac or un-embryonic sac"]
[null,"no evidencew of an embryo"]
["GD2: nodular embryo"]
[null,"solid embryonic tissue 1-4mm in length with no recognizable external features "]
[null,"and no retinal pigment"]
["GD3: cylindrical embryo<1cm"]
[null,"elongated, smooth embryos up to 1cm long without any morphologic hallmarks"]
[null," but with retinal pigment"]
["GD4: stunted embryo"]
[null,"recognizable head, trunk, and limb buds, 1-1.5cm"]
[]
["病理所見／GD分類",null,null,null,1,2,3,4,"normal"]
["gestation sac","intact containing","fluid",null,1]
[null,null,"stunted, amorphous or cylindrical embryo",null,1]
[null,null,"macerated embryo or fetus",null,null,2]
[null,null,"fresh embryo or fetus",null,null,null,3]
[null,"ruptured","absent cord root",null,1]
[null,null,"identifiable cord root","macerated",1,2]
[null,null,null,"fresh",null,null,3]
[null,null,null,"equivocal",1,2,3]
["embryo or fetus","stuntedd, amorphous or cylindrical",null,null,1]
[null,"macerated",null,null,null,2]
[null,"fresh",null,null,null,null,3]
[null,"equivocal",null,null,null,2,3]
["placenta","absent cord root",null,null,1]
[null,"identifiable cord root","macerated",null,null,2]
[null,null,"fresh",null,null,null,3]
[null,null,"equivocal",null,1,2,3]
["curettings","placental tissue"]
[null,"decidua"]
[null,"blood clot"]
[null,"other"]
["abnormal cytogenetics %",null,null,null,60,73,52,37,20]
["Poland BJ et al. Spontaneous abortion. A study of 1961 women and their conceptuses."]
["Acta Obste Gynecol Scand 1981;102:1-32."]