{Reference Type}: Journal Article
{Title}: [Chronic maternal diseases and pregnancy losses. French guidelines].
{Author}: Nizard J;Guettrot-Imbert G;Plu-Bureau G;Ciangura C;Jacqueminet S;Leenhardt L;Nedellec S;Gallot V;Vialard F;Quibel T;Huchon C;Costedoat-Chalumeau N;
{Journal}: J Gynecol Obstet Biol Reprod (Paris)
{Volume}: 43
{Issue}: 10
{Year}: Dec 2014
暂无{DOI}: 10.1016/j.jgyn.2014.09.017
{Abstract}: <B>OBJECTIVE: </B>To review the available data on maternal chronic diseases and pregnancy losses.<BR><B>METHODS: </B>We searched PubMed and the Cochrane library with pregnancy loss, stillbirth, intrauterine fetal demise, intrauterine fetal death, miscarriage and each maternal diseases of this paper.<BR><B>RESULTS: </B>Antiphospholipid antibodies (anticardiolipin, anti-beta-2-glycoprotein, lupus anticoagulant) should be measured in case of miscarriage after 10WG confirmed by ultrasound (grade B) and an antiphospholipid syndrome should be treated by a combination of aspirin and low-molecular-weight heparin during a subsequent pregnancy (grade A). We do not recommend testing for genetic thrombophilia in case of first trimester miscarriage (grade B) or stillbirth (grade C). Glycemic control should be a goal before pregnancy for women with pregestational diabetes to limit the risks of pregnancy loss (grade A) with a goal of prepregnancy HbA1c<7%. Overt and subclinical hypothyroidisms should be treated by L-thyroxin during pregnancy to reduce the risks of pregnancy loss (grade A). Women who are positive for TPOAb should have TSH concentrations follow-up during pregnancy and subsequently treated by L-thyroxin if they develop subclinical hypothyroidism (grade B).<BR><B>CONCLUSIONS: </B>Prepregnancy management of most chronic maternal diseases, ideally through prepregnancy multidisciplinary counseling, reduces the risks of pregnancy loss.