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Complications obstétricales et respiratoires au cours de la grossesse chez les patientes atteintes de mucoviscidose : une étude rétrospective unicentrique sur le CHU de Montpellier
Mémoire de Master / Thèse d'exercice   Open Access

Complications obstétricales et respiratoires au cours de la grossesse chez les patientes atteintes de mucoviscidose : une étude rétrospective unicentrique sur le CHU de Montpellier

Manon Groualle
Masters , Université de Montpellier
11/09/2024

Résumé

Maternal outcomes Mucoviscidose -- Chez la femme enceinte Complications de la grossesse Manifestations respiratoires des maladies Cystic fibrosis Pregnancy
Since the 1990s, there has been an increase in the number of patients diagnosed with cystic fibrosis, due to both an increase in the number of cases identified and an extension of life expectancy, primarily as a result of recent therapeutic advances. This is resulting in an increasing number of women with cystic fibrosis of childbearing age expressing a desire for motherhood. However, data on the impact of cystic fibrosis on pregnancy remain inconclusive. This study aims to assess obstetric and respiratory complications during pregnancy in these patients. Methods: we conducted a retrospective study from January 2012 to December 2023 at the Montpellier University Hospital, focusing on cystic fibrosis patients who experienced pregnancy during this period. We assessed the frequency of obstetric and respiratory complications among pregnancies that resulted in a live birth. Additionally, we evaluated the impact of more severe respiratory impairment or the use of triple therapy on these complications. Results: in terms of obstetric outcomes, we observed a 16% incidence of pre-eclampsia and a 43% incidence of gestational diabetes, with no reported cases of intrauterine growth restriction. The preterm birth rate was 40%, predominantly iatrogenic between 32 and 37 weeks of gestation. No significant association was identified between the severity of respiratory impairment and obstetric complications. In terms of respiratory function, most patients experienced a near-complete return to baseline pulmonary function postpartum. The use of KAFTRIO triple therapy appears to be associated with higher birth weight and enhanced respiratory function stabilization during pregnancy. Conclusion: the risk of complications during pregnancy in patients with cystic fibrosis necessitates close coordination between obstetric and respiratory teams. The advent of recent targeted therapies offers promising prospects for enhanced management of these high-risk pregnancies.

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