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Vasa prævia : quand et comment rechercher les vasa prævia en échographie et quelle prise en charge proposer aux patientes en cas de découverte d’un vasa prævia ? À propos de quatre cas et revue de la littérature

When and how should vasa praevia be looked for during ultrasound examinations, and what kind of treatment should women be offered when it is detected? Four case studies and a literature review

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Revue de médecine périnatale

Résumé

Le vasa prævia est une complication rare de la grossesse (1/2 000–1/6 000), la dilacération des vaisseaux dans l’aire cervicale de dilatation peut mener à une complication hémorragique grave d’origine foetale, l’hémorragie de Benckiser provoquant entre 75 et 100 % de mortalité. Le dépistage se réalise en cas de présence de facteurs de risques qui sont les anomalies du placenta (placenta prævia du deuxième trimestre, placenta bipartita, un ou plusieurs cotylédons aberrants), l’insertion vélamenteuse du cordon, les grossesses multiples, la fécondation in vitro. Nous proposons les modalités de dépistage et exposons la prise en charge des patientes lors de la découverte de cette complication.

Abstract

Vasa praevia is a rare complication that can arise during pregnancy (1 in 2,000-6,000 cases). Rupture of the vessels in the cervical dilation canal can lead to Benckiser’s haemorrhage, a serious fetal haemorrhage associated with a mortality rate of 75–100 %. Screening is carried out where risk factors are present. These are irregularities of the placenta (placenta praevia in the second trimester, placenta bipartita, or one or more abnormal cotyledons), velamentous cord insertion, multiple pregnancies, and in vitro fertilisation. We set out the screening procedures and outline the treatment given to pregnant women when this complication is detected.

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Authors and Affiliations

  1. Service de gynécologie obstétrique et médecine de la reproduction, CHU de Caen, avenue de la Côte de Nacre, 14000, Caen, France

    S. Mulot, L. Valentin, M. Dreyfus & G. Benoist

  2. Université de Normandie, 14000, Caen, France

    S. Mulot, L. Valentin, M. Dreyfus & G. Benoist

Authors
  1. S. Mulot
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  2. L. Valentin
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  3. M. Dreyfus
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  4. G. Benoist
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Correspondence to G. Benoist.

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Mulot, S., Valentin, L., Dreyfus, M. et al. Vasa prævia : quand et comment rechercher les vasa prævia en échographie et quelle prise en charge proposer aux patientes en cas de découverte d’un vasa prævia ? À propos de quatre cas et revue de la littérature. Rev. med. perinat. (2017). https://doi.org/10.1007/s12611-017-0423-y

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  • DOI: https://doi.org/10.1007/s12611-017-0423-y

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