Dopplervelocimetria de artérias uterinas e síndrome antifosfolípide
Palavras-chave:
dopplerfluxometria, síndrome antifosfolipídica, restrição de crescimento intra-uterino, pré-eclâmpsiaResumo
A síndrome antifosfolípide é uma condição clínica caracterizada pela presença de auto-anticorpos associada a complicações graves. Pode ocorrer trombose vascular, óbito fetal, aborto recorrente, parto prematuro, pré-eclâmpsia grave ou insuficiência placentária. O diagnóstico é feito a partir da identificação dos anticorpos antifosfolípides, principalmente do anticorpo anticardiolipina e do anticoagulante lúpico no soro materno, em associação com antecedente tromboembólico. A síndrome antifosfolípide é classificada em primária, quando ocorre isoladamente, e secundária, quando se associa a outras doenças. A dopplervelocimetria de artérias uterinas vem sendo exaustivamente estudada na tentativa de identificar as pacientes de risco para desenvolver complicações obstétricas tardias. A realização entre 18 e 24 semanas de gestação é a mais utilizada, já que é nessa fase da gestação que ocorre a segunda onda trofoblástica, diminuindo a resistência do fluxo placentário. Alguns estudos têm sugerido que as medidas dos índices de pulsatilidade, de resistência e relação A/B, associadas com a incisura diastólica, podem predizer o desenvolvimento de restrição de crescimento intra-uterino e pré-eclâmpsia. A dopplervelocimetria de artérias uterinas é um recurso diagnóstico que pode auxiliar no rastreamento da síndrome antifosfolípide, uma vez que permite identificar a placentação anormal.
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Referências
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