Prise en charge obstétricale des patientes à risque de « lupus néonatal »: Revue de la littérature
作者： N. Costedoat-Chalumeau , Z. Amoura , E. Villain , L. Cohen , L. Fermont
DOI: 10.1016/S1637-4088(06)76047-3
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摘要: Resume Les fœtus ou les enfants des femmes porteuses d’un anticorps anti-SSA/Ro et/ou anti-SSB/La peuvent developper un « lupus erythemateux neonatal » comportant une atteinte cutanee, hematologique, hepatique bloc auriculo-ventriculaire congenital (BAVc) survenant sur cœur indemne de cardiopathie malformative majeure. La frequence du BAVc chez ayant connectivite associee a est estimee 1 2 % et le risque recurrence 10 17 %. Le complet definitif associe morbidite (necessite d’implanter pace maker dans 2/3 cas) mortalite (16 19 %) faisant toute la gravite ce syndrome. Une myocardique peut etre d’emblee apparaitre tardivement. autres atteintes sont egalement discutees. Lorsqu’une femme enceinte porteuse anti-SSA/Ro, surveillance echographique obstetricale doit realisee tous 15 jours entre 16 24 SA, voire toutes semaines si elle antecedent lors d’une grossesse precedente. Un electrocardiogramme pratique principe en periode neo-natale pour depister incomplets. traitement curatif in utero fait appel aux corticoides fluores, privilegiant betamethasone. Leur efficacite inconstante.
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