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[肝脏表达的代谢性疾病合并妊娠:对母亲和孩子有哪些风险?]

[Pregnancy in metabolic diseases with hepatic expression: what risks for the mother and the child?].

作者信息

Moreau Caroline, Joueidi Yolaine, Peoc'h Katell, Bardou-Jacquet Edouard, Le Lous Maela, Bendavid Claude, Lavoué Vincent, Damaj Lena, Dessein Anne Frédérique

机构信息

Laboratoire de biochimie-toxicologie, Hôpital Pontchaillou CHU Rennes, France, Université de Rennes, Inserm, Inra, Institut NuMeCan, CHU Rennes, France.

Service de gynécologie obstétrique, Hôpital Sud CHU Rennes, France.

出版信息

Ann Biol Clin (Paris). 2019 Dec 1;77(6):605-618. doi: 10.1684/abc.2019.1497.

Abstract

Inborn errors of metabolism (IEM) are rare diseases caused by mutations in genes encoding enzymes or carriers. Qualitative or quantitative protein deficiency induces both an accumulation of precursor metabolites and a lack of products downstream of the blockade. Pregnancy in patients with IEM is a condition likely to promote metabolic decompensation. In this review, we presented liver symptoms described during pregnancy in a context of hepatic IEM. In particular, we detailed clinical and biological abnormalities specifically occurring in tyrosinemia type I, Wilson disease, and main urea cycle defects. In the case of hepatic IEM, depending on the deficit, pregnant women have an increased risk of pre-eclampsia and HELLP syndrome, as well as hyperammonemia. Wilson disease, and principal urea cycle defects. Multidisciplinary consultation is essential for the optimal management of pregnant women with IEM as well as newborns.

摘要

先天性代谢缺陷(IEM)是由编码酶或载体的基因突变引起的罕见疾病。定性或定量的蛋白质缺乏会导致前体代谢物的积累以及阻断下游产物的缺乏。IEM患者怀孕很可能会促使代谢失代偿。在本综述中,我们阐述了在肝脏IEM背景下孕期出现的肝脏症状。特别是,我们详细介绍了I型酪氨酸血症、威尔逊病和主要尿素循环缺陷中特有的临床和生物学异常情况。对于肝脏IEM,根据缺陷情况,孕妇患先兆子痫和HELLP综合征以及高氨血症的风险会增加。威尔逊病和主要尿素循环缺陷。多学科会诊对于IEM孕妇及新生儿的最佳管理至关重要。

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