状细胞疾病和怀孕
Julie Carrara1, Anoosha Habibi2, Alexandra Benachi1
1Service de Gynécologie-Obstétrique, Hôpital Antoine Béclère, AP-HP, Université Paris Saclay, 92140 Clamart, France.
Presse medicale (Paris, France : 1983)
|November 8, 2023
概括
怀孕对状细胞病 (SCD) 患者构成重大风险,增加了母亲和婴儿的并发症. 精心规划和多学科护理对于在怀孕期间管理SCD至关重要.
科学领域:
- 血液学 血液学 血液学
- 产科 产科 产科 产科 产科
- 遗传学 是一个遗传学.
背景情况:
- 怀孕对于患有状细胞病 (SCD) 的人来说是一个高风险时期,包括各种血红蛋白病,如Hb S/C和S/β-thalassemia.
- 怀孕期间的生理适应加剧了诸如血管闭塞危机 (VOC),急性胸部综合征,血栓栓塞事件和感染等风险.
研究的目的:
- 概述状细胞疾病的孕妇患者的高风险和必要的管理策略.
- 强调怀孕前咨询和多学科护理的重要性,以优化孕产妇和胎儿的结果.
主要方法:
- 审查现有的文献和临床指南关于SCD在怀孕期间的管理.
- 讨论孕前咨询,包括遗传传染风险和父母查 (血红蛋白电泳).
- 对治疗修改的分析,包括停用氧尿素 (HU) 和预防性输血的指示.
主要成果:
- SCD显著增加了产科并发症的可能性,包括子宫前,子宫内胎儿死亡,早产和子宫内生长限制.
- 建议使用输血等预防策略是基于特定的标准,而不是普遍适用的.
- 由于孕产妇的风险,对胎儿肺成熟的系统性皮质类固醇的使用是禁忌的;提供了分娩时间建议.
结论:
- 在SCD患者的怀孕需要精心规划和专业的多学科团队的密切监测.
- 管理涉及预孕咨询,调整药物,如基尿素,和选择性使用干预措施,如输血.
- 产后监测是非常重要的,因为持续的风险,特别是血栓栓塞.
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