Pravastatin to prevent recurrent fetal death in massive perivillous fibrin deposition of the placenta (MPFD).
Pravastatin to prevent recurrent fetal death in massive perivillous fibrin deposition of the placenta (MPFD).
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DOI：
10.3109/14767058.2015.1022864
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发表时间：
2016-03
期刊：
影响因子：
--
通讯作者：
Hassan SS
中科院分区：
文献类型：
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作者：
Chaiworapongsa T;Romero R;Korzeniewski SJ;Chaemsaithong P;Hernandez-Andrade E;Segars JH;DeCherney AH;McCoy MC;Kim CJ;Yeo L;Hassan SS
胎盘大量绒毛周围纤维蛋白沉积 (MPFD) 或母体底梗死 (MFI) 是一种与反复发生的并发症相关的严重疾病，包括胎儿死亡和严重的胎儿生长受限。没有方法可以评估后续怀孕中不良后果的风险，也没有有效的预防措施。最近的观察表明，MFI 的特点是妊娠早期血管生成/抗血管生成因子失衡；因此，这些生物标志物的测定可以识别有复发风险的患者。我们报告了一名孕妇的病例，她有连续四次流产史，其中最后一次流产受到了 MFI 的影响。在妊娠早期检测到抗血管生成因子、sVEGFR-1 和可溶性内皮糖蛋白 (sEng) 异常，并用普伐他汀治疗纠正了异常。治疗后，一名妊娠 34 周的活产婴儿在 2 岁时具有正常的生物特征参数和发育里程碑。这是首次报道成功使用普伐他汀逆转血管生成/抗血管生成失衡并防止胎儿死亡。
Massive perivillous fibrin deposition of the placenta (MPFD) or maternal floor infarction (MFI) is a serious condition associated with recurrent complications including fetal death and severe fetal growth restriction. There is no method to evaluate the risk of adverse outcome in subsequent pregnancies, or effective prevention. Recent observations suggest that MFI is characterized by an imbalance in angiogenic/anti-angiogenic factors in early pregnancy; therefore, determination of these biomarkers may identify the patient at risk for recurrence. We report the case of a pregnant woman with a history of four consecutive pregnancy losses, the last of which was affected by MFI. Abnormalities of the anti-angiogenic factor, sVEGFR-1, and soluble endoglin (sEng) were detected early in the index pregnancy, and treatment with pravastatin corrected the abnormalities. Treatment resulted in a live birth infant at 34 weeks of gestation who had normal biometric parameters and developmental milestones at the age of 2. This is the first reported successful use of pravastatin to reverse an angiogenic/anti-angiogenic imbalance and prevent fetal death.