de Moreuil Claire, Remoué Annabelle, Pozzi Jordan, Trémouilhac Christophe, Anouilh François, Morcel Karine, Marcorelles Pascale
Département de médecine vasculaire, médecine interne et pneumologie, CHU de Brest, hôpital La Cavale Blanche, Brest cedex, France; UMR1304, GETBO, Inserm, université de Brest, 29200 Brest, France.
Service d'anatomopathologie, CHU de Brest, hôpital Morvan, Brest cedex, France.
Rev Med Interne. 2025 Feb;46(2):107-115. doi: 10.1016/j.revmed.2024.09.001. Epub 2024 Sep 21.
Vasculo-placental disorders include pregnancy complications resulting from placental dysfunction of vascular origin, i.e. pre-eclampsia, HELLP syndrome, intrauterine growth retardation (IUGR), placental abruption and stillbirth of vascular origin. Pre-eclampsia should be investigated for antiphospholipid syndrome (APS) in case of severe pre-eclampsia and premature delivery before 34 weeks of gestation. In addition to testing for APS, pathological report of the placenta can identify some anatomical predispositions to placental vascular malperfusion, as well as chronic placental inflammatory lesions and excess fibrin deposits. The latter two are associated with IUGR and recurrent stillbirth, reflecting a dysimmune process of maternal origin. The internal medicine and obstetrics consultation, organized two months after delivery, combines the postnatal visit with an assessment of the causes of vasculo-placental disorders, and enables to inform patients about the management of future pregnancies and their cardiovascular health.