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Ginecología y Obstetricia de México

Federación Mexicana de Ginecología y Obstetricia, A.C.
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2022, Number 07

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Ginecol Obstet Mex 2022; 90 (07)

Hereditary hemorrhagic telangiectasia during pregnancy: Case report

Guzmán-López A, Treviño-Montemayor ÓR, Trejo-Guzmán EJ, Soria-López JA, Guzmán-Pérez TI
Full text How to cite this article

Language: Spanish
References: 8
Page: 623-628
PDF size: 191.89 Kb.


Key words:

Hereditary hemorrhagic telangectasia, Osler-Weber-Rendu syndrome, Arteriovenous malformations, Endoglin, Epistaxis, Pregnancy.

ABSTRACT

Background: Hereditary hemorrhagic telangiectasia, or Rendu-Osler-Weber syndrome, is an autosomal inherited vascular disease characterized by mucocutaneous telangiectasias and arteriovenous malformations in the lung, brain and liver. The estimated prevalence is 1.5 to 2 affected persons per 10,000 population. Ninety percent of cases are due to a mutation in the endoglin gene and in the activin receptor-like kinase 1 gene (ACVRL1). In pregnant women, hereditary hemorrhagic telangiectasia is high risk, especially during the second and third trimester.
Objective: To report a case of hereditary hemorrhagic telangiectasia and to expose the complications that can occur during pregnancy.
Clinical case: 23-year-old patient, with hereditary family history of mother diagnosed with hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome) who died at 38 years of age. Personal pathological history of hereditary hemorrhagic telangiectasia, diagnosed at the age of 12 years after multiple episodes of epistaxis. She was treated with multiple blood transfusions and 200 mg of ferrous sulfate every 24 hours.
Conclusion: Hereditary hemorrhagic telangiectasia conditions, in pregnant women, the appearance of complications that can put the life of the mother and fetus at risk. Women with a known history should be evaluated before conception in order to know the status of the disease.


REFERENCES

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  2. Bari O, Cohen PR. Hereditary hemorrhagic telangiectasiaand pregnancy: potential adverse events and pregnancyoutcomes. Int J Women’s Health 2017; 9, 373-78. https://doi.org/10.2147/IJWH.S131585

  3. González Escudero M, Sosa Estébanez M, Pérez AcostaND. Telangiectasia hemorrágica hereditaria enuna gestante. Medisan 2018; 22 (1): 65-70. http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1029-30192018000100009&lng=es

  4. Bustamante F, Tenreiro Picón O, Tenreiro A, et al. Síndromede Rendu-Osler-Weber: presentación de un caso clínico.Avan Biomed 2016; 5 (2). https://www.redalyc.org/pdf/3313/331347417009.pdf

  5. Dupuis O, Delagrange L, Dupuis-Girod S, et al. Hereditaryhaemorrhagic telangiectasia and pregnancy: a review ofthe literature. Orphanet J Rare Dis 2020; 15 (1): 1-9. https://doi.org/10.1186/s13023-019-1286-z

  6. de Gussem EM, Lausman AY, Beder AJ, et al. Outcomesof pregnancy in women with hereditary hemorrhagictelangiectasia. Obstet Gynecol 2014; 123 (3): 514-20.doi:10.1097/AOG.0000000000000120

  7. Shovlin CL, Sodhi V, McCarthy A, et al. Estimates of maternalrisks of pregnancy for women with hereditary haemorrhagictelangiectasia (Osler-Weber-Rendu syndrome):suggested approach for obstetric services. BJOG 2008;115 (9): 1108-15. doi: 10.1111/j.1471-0528.2008.01786.x

  8. Faughnan ME, Mager JJ, Hetts SW, et al. Second internationalguidelines for the diagnosis and management of hereditaryhemorrhagic telangiectasia. Ann Intern Med 2020;173 (12): 989-1001. https://doi.org/10.7326/M20-1443




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Ginecol Obstet Mex. 2022;90