[Combining corticosteroid and aspirin for the prevention of recurrent villitis or intervillositis of unknown etiology].
We report the cases of two patients who had a favorable outcome with aspirin and corticosteroid therapy during pregnancy for chronic villitis of unknown etiology complicated by labor asphyxia and further intrauterine fetal demise in one gravida 3 patient and for chronic intervillositis of unknown etiology diagnosed after three perinatal deaths in another patient (gravida 4). Chronic villitis of unknown etiology (CVUE) is detected in 7 to 33% of placentas, mainly after intrauterine growth retardation (IUGR), unexplained prematurity, preeclampsia, perinatal asphyxia and intrauterine fetal death (IUFD). The less frequent chronic intervillositis of unknown etiology (CIUE) (0.6 to 0.9/1.000) has been implicated in recurrent severe pregnancy complications, such as spontaneous abortions, IUGR and IUFD. Histopathology and immunohistology are in favor of an immune response against the foreign fetal allograft. The favorable results obtained with corticosteroids and aspirin remain to be confirmed by larger series.
Boog
G
G
Service de Gynécologie-Obstétrique, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes Cedex 1. georges.boog@chu-nantes.fr
Le Vaillant
C
C
Alnoukari
F
F
Jossic
F
F
Barrier
J
J
Muller
J-Y
JY
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use*; D002824:Chorionic Villi / Q000276:immunology / Q000473:pathology; D004359:Drug Therapy, Combination; D005260:Female; D005317:Fetal Growth Retardation / Q000209:etiology; D006801:Humans; D007150:Immunohistochemistry; D007231:Infant, Newborn; D007249:Inflammation / Q000150:complications / Q000276:immunology / Q000517:prevention & control; D008297:Male; D010922:Placenta Diseases / Q000188:drug therapy* / Q000276:immunology / Q000517:prevention & control; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000276:immunology / Q000517:prevention & control; D011256:Pregnancy Outcome; D055502:Secondary Prevention
D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin