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/Title (Grossesse et auto-immunit : exprience monocentrique de 2002 2012, intrt d'une prise en charge multidisciplianire)
/Author (Franois-Xavier Lapebie)
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/Subject (Le lupus rythmateux systmique \(LES\), le syndrome des anticorps antiphospholipides \(SAPL\) et la thyrodite de Hashimoto sont les maladies auto-immunes les plus frquemment rencontres au cours de la grossesse. Elles exposent celle-ci des pertes ftales, des complications ftales et des complications maternelles. La grossesse retentit galement sur la maladie auto-immune, favorisant les pousses volutives. Enfin la mise en vidence danticorps antiphospholipides \(aPL\) au cours de la grossesse en dehors dun SAPL dfini est une situation frquente, et semble associe aux complications obsttricales. La prise en charge de ces patientes est complexe, et souffre dun manque de consensus. Une prise en charge multidisciplinaire est probablement ncessaire. Nous rapportons 165 grossesses chez 109 patientes diffrentes, prises en charge entre 2002 et 2012 dans un seul centre par une quipe associant des mdecins internistes, obsttriciens et anesthsistes : un SAPL tait prsent pour 14.5% des grossesses, des aPL hors SAPL pour 50.9%, un LES pour 33.3% et une dysthyrodie et/ou des anti-TPO pour 24.2%. Des complications obsttricales antrieures taient retrouves pour 75.8% des grossesses. Sur les 165 grossesses, 43% taient traites par aspirine faible dose, 35.2% par aspirine et hparine de bas poids molculaire \(HBPM\) dose prventive, 10.9% par aspirine et HBPM dose curative, 38.3% par hydroxychloroquine et 43.8% par prednisone faible dose. Le taux de naissances vivantes tait de 89.1%. Des complications obsttricales survenaient pour 80.6% des grossesses. Notre srie souligne limportance dune prise en charge multidisciplinaire de ces grossesses.)
/Keywords ("Grossesse|Maladies autoimmunes chez la femme enceinte|Lupus rythmateux aigu dissmin,Anticorps antiphospholipide,Thyrodite autoimmune")
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Grossesse et auto-immunité : expérience monocentrique de 2002 à 2012, intérêt d'une prise en charge multidisciplianire
François-Xavier Lapebie
Le lupus érythémateux systémique (LES), le syndrome des anticorps antiphospholipides (SAPL) et la thyroïdite de Hashimoto sont les maladies auto-immunes les plus fréquemment rencontrées au cours de la grossesse. Elles exposent celle-ci à des pertes fœtales, à des complications fœtales et à des complications maternelles. La grossesse retentit également sur la maladie auto-immune, favorisant les poussées évolutives. Enfin la mise en évidence d’anticorps antiphospholipides (aPL) au cours de la grossesse en dehors d’un SAPL défini est une situation fréquente, et semble associée aux complications obstétricales. La prise en charge de ces patientes est complexe, et souffre d’un manque de consensus. Une prise en charge multidisciplinaire est probablement nécessaire. Nous rapportons 165 grossesses chez 109 patientes différentes, prises en charge entre 2002 et 2012 dans un seul centre par une équipe associant des médecins internistes, obstétriciens et anesthésistes : un SAPL était présent pour 14.5% des grossesses, des aPL hors SAPL pour 50.9%, un LES pour 33.3% et une dysthyroïdie et/ou des anti-TPO pour 24.2%. Des complications obstétricales antérieures étaient retrouvées pour 75.8% des grossesses. Sur les 165 grossesses, 43% étaient traitées par aspirine à faible dose, 35.2% par aspirine et héparine de bas poids moléculaire (HBPM) à dose préventive, 10.9% par aspirine et HBPM à dose curative, 38.3% par hydroxychloroquine et 43.8% par prednisone à faible dose. Le taux de naissances vivantes était de 89.1%. Des complications obstétricales survenaient pour 80.6% des grossesses. Notre série souligne l’importance d’une prise en charge multidisciplinaire de ces grossesses.
Grossesse|Maladies autoimmunes chez la femme enceinte|Lupus érythémateux aigu disséminé,Anticorps antiphospholipide,Thyroïdite autoimmune
2013-09-18T23:47:30+02:00
PScript5.dll Version 5.2.2
2014-06-23T11:54:34+02:00
Acrobat Distiller 8.0.0 (Windows)
Grossesse|Maladies autoimmunes chez la femme enceinte|Lupus érythémateux aigu disséminé,Anticorps antiphospholipide,Thyroïdite autoimmune
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