sábado, 9 de noviembre de 2013

Trombofilias y embarazo

Plaquetas en el embarazo 
Platelets in pregnancy.
Juan P, Stefano G, Antonella S, Albana C.
Poliambulatorio di Ceprano, Ospedale SS Trinita di Sora, Ultrasound in Obstetrics and Gynecology Divisions; (FR), Italy.
J Prenat Med. 2011 Oct;5(4):90-2.
As stated in this review, platelets functions and their important role in coagulabity in pregnancy must be well understood, not only in thrombosis related complications in pregnancy (i.e., hypertension, diabetes, thrombophilia).Clinical findings suggest that a periodical monitoring of haematological markers such as MPV and coagulation markers may be associated to Doppler velocimetry, keeping in mind also that the incidence of complications is increased in women who have heritable platelet function disorders.
KEYWORDS: coagulation, high risk pregnancies, platelets 
Trombofilias y daño renal durante el embarazo
Thrombophilia and damage of kidney during pregnancy.
Giovanni L, Maria LG, Mauro R, Carlotta M, Federica R, Fabrizio P, Sheba J, Giuseppe DP, Alessandro B, Elio C, Herbert V.
Department of Obstetrics and Gynaecology, Fatebenefratelli Isola TiberinaHospital, Rome.
J Prenat Med. 2011 Oct;5(4):78-82.
OBJECTIVES:It's known that heritable thrombophilias are a risk factor for the development of obstetrics complications associated to inadequate uterine-placental circulation, as pre-eclampsia/eclampsia, HELLP syndrome, placental abruption and intrauterine growth restriction (IUGR), however it was never investigated the role that they could have in the renal failure associated to such conditions. The purpose of this study is to evaluate ifthrombophilia itself that predispose to a possible renal damage or if its occurrence determines a more severe involvement of the kidneys in the course of these obstetric pathologies. METHODS: In the study were enrolled 301 pregnant women, who carried a thrombophilic state, 125 of whom (B group) has had an obstetric complication. In all the women the renal function was assessed taking into consideration proteinuria, creatininaemia and hypalbuminaemia. RESULTS:Of the three parameters which have been considered as evidence of a severe renal involvement the hypalbuminaemia appears statistically significant compared to the controls. Even creatinaemia is significantly increased in pregnant women with an Anthithrombin deficiency, and increased levels are detected in women with Factor V Leiden. CONCLUSIONS: In obstetric complications associated to thrombophilic state could be a more severe involvement of the kidney.
KEYWORDS: heritable thrombophilias, obstetric complications, renal damage in pregnancy
Síndrome antifosfolípido durante el embarazo: estado del arte 
Antiphospholipid Syndrome during pregnancy: the state of the art.
Di Prima FA, Valenti O, Hyseni E, Giorgio E, Faraci M, Renda E, De Domenico R, Monte S.
Policlinico Hospital, Department of Obstetrics and Gynecology, University of Catania, Italy.
J Prenat Med. 2011 Apr;5(2):41-53.
Obstetric complications are the hallmark of antiphospholipid syndrome. Recurrent miscarriage, early delivery, oligohydramnios, prematurity, intrauterine growth restriction, fetal distress, fetal or neonatal thrombosis, pre-eclampsia/eclampsia, HELLP syndrome, arterial or venous thrombosis and placental insufficiency are the most severe APS-related complication for pregnant women. Antiphospholipid antibodies promote activation of endothelial cells, monocytes and platelets, causing an overproduction of tissue factor and thromboxane A2. Complement activation might have a central pathogenetic role. These factors, associated with the typical changes in the hemostatic system during normal pregnancy, result in a hypercoagulable state. This is responsible of thrombosis that is presumed to provoke many of the pregnancy complications associated with APS. Obstetric care is based on combined medical-obstetric high-risk management and treatment with the association between aspirin and heparin. This review aims to deter- mine the current state of the art of APS by investigating the knowledge achievements of recent years, to provide the most appropriate diagnostic and therapeutic management for pregnant women suffering from this syndrome.
KEYWORDS:Antiphospholipid, Hypercoagula- bility, Thrombophilia, Thromboprophylaxis.

Dr. Benito Cortes-Blanco
Anestesiología y Medicina del Dolor

Publicar un comentario