Successful pregnancy following treatment of recurrent chronic histiocytic intervillositis.
Leehe VardiHelen PatersonNoelyn Anne HungPublished in: BMJ case reports (2017)
Chronic histiocytic intervillositis (CHI) is a rare placental lesion associated with adverse obstetric outcomes and high recurrence rate. We report a case of six consecutive pregnancies in one woman, where CHI was detected following an intrauterine death in the fifth pregnancy, after being missed in four earlier losses. The successful sixth pregnancy was treated with a combination of immunosuppressive and antithrombotic agents. While low-molecular-weight heparin (LMWH) and aspirin had been shown to improve pregnancy outcome in recurrent pregnancy loss, there was limited evidence of improved outcome in CHI. It has been suggested that CHI may result from a maternal immunological process and there have been a few reports of the use of corticosteroids because of this possibility, though without convincing evidence of efficacy. We too tried a corticosteroid, in combination with LMWH and aspirin. Comparative histopathological analysis of the placentae supported post-treatment effectiveness of our intervention strategy.
Keyphrases
- pregnancy outcomes
- preterm birth
- randomized controlled trial
- pregnant women
- low dose
- cardiovascular events
- emergency department
- cardiovascular disease
- metabolic syndrome
- gestational age
- venous thromboembolism
- weight loss
- atrial fibrillation
- skeletal muscle
- acute coronary syndrome
- antiplatelet therapy
- birth weight
- newly diagnosed
- case report
- weight gain