Summary
Samenvatting Pathologie Diabetes Mellitus
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Samenvatting pathologie diabetes mellitus
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Obstetrische aspecten vanMedische Pathologie
Trombofilie
= Afwijkingen van de bloedstolling
Antifosfolipidensyndroom
= Auto-immune aandoening gekenmerkt door een verhoogde bloedstolling Ontstaan
trombose(s)
Gekoppeld aan:
Aanwezigheid van Lupus anticoagulans en Anticardiolipine
Diagnose
Meest tussen 20 en 40jaar
Auto-immune aantasting van alle organen
Gewrichten ( Arthritis)
Huid
Longen ( Chronische inflammatie)
Andere orgaansystemen ( Hart en nieren)
Klinische factoren
Trombose(s) & Arterieel en veneus (diep veneuze trombose of longembool)
Zwangerschapsverwikkelingen
Herhaald miskraam
Intra-uteriene groeirestrictie
Abruptio
Placentaire infarcten
Maternale risico’s
Diep veneuze trombose
Significant lager (1%) bij behandeling met LMWH (= Heparine)
Longembool
Significant lager (1%) bij behandeling met LMWH (= Heparine)
Obstetrische risico’s
Miskraam … < 10weken < …
Mors in utero
Intra-uteriene groeirestrictie
Pre-eclampsie
, Therapie
Anticoagulantia
Prenatale opvolging
Aandachtspunten prenataal:
Trimester 1: Labo/Nierfunctie/Plaatjes/Proteïnurie/Leverfunctie
Screening voor Lupus anticoagulans en Anticardiolipine
Echografische opvolging
Non stress test
Regelmatige opvolging moeder door internist
Peripartum beleid
Stop Asaflow op 36weken
Bevallen op 39weken
Noodzaak stop LMWH 24h prepartum
Postpartum beleid
Anticoagulantia ( LMWH of Warfarin (Anti vitK))
Vaginale partus: 4 tot 6uur erna
Sectio: 6 tot 12uur erna
Preventie miskraam en zwangerschapsverwikkelingen
Behandeling met Asaflow en Fraxiparine
Thromboprofylaxie ook postpartum!
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