Quel bilan proposer après une grossesse compliquée de pathologie vasculo-placentaire ?

IF 0.7 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Revue De Medecine Interne Pub Date : 2025-02-01 DOI:10.1016/j.revmed.2024.09.001

Claire de Moreuil , Annabelle Remoué , Jordan Pozzi , Christophe Trémouilhac , François Anouilh , Karine Morcel , Pascale Marcorelles

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Abstract

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.

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[妊娠并发血管-胎盘疾病后应进行哪些检查？］

血管-胎盘疾病包括血管性胎盘功能障碍导致的妊娠并发症，即先兆子痫、HELLP 综合征、胎儿宫内发育迟缓（IUGR）、胎盘早剥和血管性死胎。如果出现严重的先兆子痫和妊娠 34 周前早产，则应进行抗磷脂综合征（APS）检查。除了检测 APS 外，胎盘的病理报告还可以确定胎盘血管灌注不良的一些解剖倾向，以及胎盘慢性炎症病变和纤维蛋白沉积过多。后两者与 IUGR 和复发性死胎有关，反映了母体免疫异常过程。产后两个月组织的内科和产科会诊结合了产后访视和血管-胎盘疾病原因评估，使患者能够了解未来妊娠的管理及其心血管健康状况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revue De Medecine Interne 医学-医学：内科

CiteScore

0.70

自引率

11.10%

发文量

526

审稿时长

37 days

期刊介绍： Official journal of the SNFMI, La revue de medecine interne is indexed in the most prestigious databases. It is the most efficient French language journal available for internal medicine specialists who want to expand their knowledge and skills beyond their own discipline. It is also the main French language international medium for French research works. The journal publishes each month editorials, original articles, review articles, short communications, etc. These articles address the fundamental and innumerable facets of internal medicine, spanning all medical specialties. Manuscripts may be submitted in French or in English. La revue de medecine interne also includes additional issues publishing the proceedings of the two annual French meetings of internal medicine (June and December), as well as thematic issues.