Recurrent Massive Perivillous Fibrin Deposition and Chronic Intervillositis Treated With Heparin and Intravenous Immunoglobulin: A Case Report
Recurrent Massive Perivillous Fibrin Deposition and Chronic Intervillositis Treated With Heparin and Intravenous Immunoglobulin: A Case Report
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DOI：
10.1016/j.jogc.2017.03.089
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发表时间：
2017-08-01
影响因子：
1.8
通讯作者：
Grynspan, David
中科院分区：
文献类型：
--
作者：
Abdulghani, Sahar;Moretti, Felipe;Grynspan, David
背景资料：大量绒毛周纤维蛋白沉积（MPVFD）和慢性绒毛间炎（CI）是严重宫内生长受限（IUGR）和胎儿丢失的罕见病理相关因素，具有高复发率。没有标准的管理已建立。案例：一个病人进行终止妊娠21周的严重早发IUGR。胎盘组织学显示混合CI和MPVFD。几个月后，患者怀孕，并接受泼尼松和阿司匹林（阿萨）治疗，但在16周时流产。胎盘病理学显示MPVFD和局灶性CI。在随后的两次妊娠中，她接受了静脉注射免疫球蛋白（IVIG）、肝素和阿萨治疗。两次妊娠均导致健康的近足月分娩，胎盘正常。结论：IVIG、肝素和阿萨可作为MPVFD和CI所致反复妊娠丢失患者的一种选择。
Background: Massive perivillous fibrin deposition (MPVFD) and chronic intervillositis (CI) are related rare pathological correlates of severe intrauterine growth restriction (IUGR) and fetal loss with high recurrence rates. No standard management has been established.Case: A patient underwent termination of pregnancy at 21 weeks for severe early onset IUGR. Placental histology showed mixed CI with MPVFD. Several months later, the patient became pregnant and was managed with prednisone and aspirin (ASA) but miscarried at 16 weeks. Placental pathology showed MPVFD and focal CI. For two subsequent pregnancies, she was treated with intravenous immunoglobulin (IVIG), heparin, and ASA. Both pregnancies resulted in healthy near-term deliveries with normal placentas.Conclusion: IVIG, heparin, and ASA can be an option in patients with recurrent pregnancy loss due to MPVFD and CI.