[Which workup should be performed after a pregnancy complicated with vasculo-placental disorder?]

Autor: de Moreuil C; Département de médecine vasculaire, médecine interne et pneumologie, CHU de Brest, hôpital La Cavale Blanche, Brest cedex, France; UMR1304, GETBO, Inserm, université de Brest, 29200 Brest, France. Electronic address: claire.demoreuil@chu-brest.fr., Remoué A; Service d'anatomopathologie, CHU de Brest, hôpital Morvan, Brest cedex, France., Pozzi J; Service de gynécologie et d'obstétrique, CHU de Brest, hôpital Morvan, Brest cedex, France., Trémouilhac C; Service de gynécologie et d'obstétrique, centre hospitalier des Pays de Morlaix, Morlaix cedex, France., Anouilh F; UMR1304, GETBO, Inserm, université de Brest, 29200 Brest, France; Service de gynécologie et d'obstétrique, CHU de Brest, hôpital Morvan, Brest cedex, France; École universitaire de Maïeutique de Brest, université de Brest, 29200 Brest, France., Morcel K; UMR1304, GETBO, Inserm, université de Brest, 29200 Brest, France; Service de gynécologie et d'obstétrique, CHU de Brest, hôpital Morvan, Brest cedex, France., Marcorelles P; Service d'anatomopathologie, CHU de Brest, hôpital Morvan, Brest cedex, France; EA4685, LIEN, Inserm, universiyé de Brest, 29200 Brest, France.
Jazyk: francouzština
Zdroj: La Revue de medecine interne [Rev Med Interne] 2024 Sep 21. Date of Electronic Publication: 2024 Sep 21.
DOI: 10.1016/j.revmed.2024.09.001
Abstrakt: Vasculo-placental disorders include pregnancy complications resulting from placental dysfunction of vascular origin, i.e. pre-eclampsia, HELLP syndrome, intrauterine growth retardation (IUGR), placental abruption and stillbirth of vascular origin. Pre-eclampsia should be investigated for antiphospholipid syndrome (APS) in case of severe pre-eclampsia and premature delivery before 34 weeks of gestation. In addition to testing for APS, pathological report of the placenta can identify some anatomical predispositions to placental vascular malperfusion, as well as chronic placental inflammatory lesions and excess fibrin deposits. The latter two are associated with IUGR and recurrent stillbirth, reflecting a dysimmune process of maternal origin. The internal medicine and obstetrics consultation, organized two months after delivery, combines the postnatal visit with an assessment of the causes of vasculo-placental disorders, and enables to inform patients about the management of future pregnancies and their cardiovascular health.
(Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)
Databáze: MEDLINE
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