{"id":2275,"date":"2025-11-25T10:53:41","date_gmt":"2025-11-25T09:53:41","guid":{"rendered":"https:\/\/www.doctorasantillanpalencia.es\/?page_id=2275"},"modified":"2026-10-07T17:24:18","modified_gmt":"2026-10-07T15:24:18","slug":"grossesse-a-haut-risque","status":"publish","type":"page","link":"https:\/\/www.doctorasantillanpalencia.es\/fr\/grossesse-a-haut-risque\/","title":{"rendered":"Grossesse \u00e0 haut risque"},"content":{"rendered":"\t\t
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Suivi de la grossesse \u00e0 haut risque<\/h1><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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Fausses couches \u00e0 r\u00e9p\u00e9tition. Certains facteurs augmentent le risque de complications de la grossesse chez la m\u00e8re, chez le f\u0153tus ou chez les deux, et n\u00e9cessitent un suivi plus approfondi et sp\u00e9cialis\u00e9 pour r\u00e9duire ces risques. Parmi ces facteurs figurent:<\/p>

  • Ant\u00e9c\u00e9dents obst\u00e9tricaux et fausses couches \u00e0 r\u00e9p\u00e9tition : Les femmes ayant eu des complications lors de grossesses pr\u00e9c\u00e9dentes peuvent pr\u00e9senter un risque accru de complications lors des grossesses suivantes. Elles n\u00e9cessitent une \u00e9tude d\u00e9taill\u00e9e des facteurs pr\u00e9disposants. On consid\u00e8re comme mauvais ant\u00e9c\u00e9dents obst\u00e9tricaux l\u2019existence de fausses couches \u00e0 r\u00e9p\u00e9tition, d\u2019accouchements pr\u00e9matur\u00e9s, de mort f\u0153tale in utero, de retard de croissance intra-ut\u00e9rin, etc.<\/li>
  • Facteurs immunologiques et syndrome des antiphospholipides. Il existe de multiples facteurs immunologiques qui peuvent emp\u00eacher un embryon sain de s\u2019implanter ou, m\u00eame apr\u00e8s l\u2019implantation, provoquer une fausse couche. Le facteur immunologique qui cause le plus clairement des probl\u00e8mes de fertilit\u00e9 est le syndrome des antiphospholipides. Dans ce syndrome, la m\u00e8re produit des anticorps anormaux qui, en plus de provoquer des thromboses et des saignements, peuvent entra\u00eener le rejet immunologique du b\u00e9b\u00e9 et donc des fausses couches. Son diagnostic passe souvent inaper\u00e7u, soit parce que les anticorps concern\u00e9s ne sont pas demand\u00e9s, soit parce que leurs seuils ne sont pas bien interpr\u00e9t\u00e9s. Le traitement par h\u00e9parine et acide ac\u00e9tylsalicylique, s\u2019il est bien ajust\u00e9, suffit g\u00e9n\u00e9ralement \u00e0 mener \u00e0 bien une grossesse \u00e0 terme.<\/li>
  • L\u2019hypothyro\u00efdie est une cause de fausses couches \u00e0 r\u00e9p\u00e9tition. Elle est g\u00e9n\u00e9ralement d\u2019origine auto-immune. La suppl\u00e9mentation en hormone thyro\u00efdienne jusqu\u2019\u00e0 l\u2019obtention de valeurs de TSH ad\u00e9quates permet, dans la plupart des cas, une grossesse r\u00e9ussie et des b\u00e9b\u00e9s en bonne sant\u00e9. Parfois, la grossesse elle-m\u00eame peut provoquer une thyro\u00efdite qui persiste ensuite apr\u00e8s l\u2019accouchement.<\/li>
  • Diab\u00e8te sucr\u00e9. Les femmes atteintes de diab\u00e8te pr\u00e9gestationnel sont consid\u00e9r\u00e9es comme \u00e0 risque plus \u00e9lev\u00e9, et un contr\u00f4le optimal de la glyc\u00e9mie est n\u00e9cessaire dans les mois qui pr\u00e9c\u00e8dent une tentative de grossesse afin de r\u00e9duire le risque de fausse couche et de malformations. Le diab\u00e8te qui appara\u00eet pendant la grossesse s\u2019appelle diab\u00e8te gestationnel et n\u00e9cessite \u00e9galement une surveillance accrue, car il est associ\u00e9 \u00e0 davantage de complications.<\/li>
  • Pr\u00e9\u00e9clampsie, hypertension ou maladie maternelle chronique. La pr\u00e9\u00e9clampsie est la triade clinique associant hypertension, prot\u00e9inurie et \u0153d\u00e8mes chez une femme enceinte. Sa cause est immunitaire et vasculaire, ce qui peut entra\u00eener des complications telles que retard de croissance f\u0153tale, pathologie placentaire, \u00e9clampsie, etc. Les femmes atteintes d\u2019hypertension chronique, d\u2019ob\u00e9sit\u00e9 ou de diab\u00e8te gestationnel ont un risque plus \u00e9lev\u00e9 de la d\u00e9velopper. Au cours du premier trimestre de la grossesse, il existe des marqueurs cl\u00e9s pour d\u00e9tecter le risque de pr\u00e9\u00e9clampsie et pr\u00e9venir les formes s\u00e9v\u00e8res par l\u2019aspirine (AAS). Ces marqueurs sont : un facteur de croissance placentaire (PlGF) bas, une prot\u00e9ine antiangiog\u00e9nique (sFlt-1) \u00e9lev\u00e9e, un indice de pulsatilit\u00e9 des art\u00e8res ut\u00e9rines (UtA-PI) \u00e9lev\u00e9 et une hypertension maternelle.<\/li>
  • Incomp\u00e9tence cervicale. L\u2019incomp\u00e9tence ou insuffisance cervicale survient lorsque le col de l\u2019ut\u00e9rus se dilate et s\u2019ouvre pr\u00e9matur\u00e9ment pendant la grossesse. Elle provoque typiquement des fausses couches tardives et des accouchements pr\u00e9matur\u00e9s. Pour la diagnostiquer \u00e0 temps, il est recommand\u00e9 de mesurer la longueur du col par \u00e9chographie endovaginale. Le traitement n\u00e9cessite souvent un cerclage, ou suture du col, associ\u00e9 au repos. L\u2019ad\u00e9nomyose, les malformations ut\u00e9rines et d\u2019autres pathologies ut\u00e9rines pr\u00e9existantes tendent \u00e0 diminuer la distensibilit\u00e9 et la vascularisation de l\u2019ut\u00e9rus, ce qui g\u00eane la placentation et augmente les complications aussi bien pendant la grossesse (fausse couche, RCIU, accouchement pr\u00e9matur\u00e9, placenta praevia\u2026) qu\u2019\u00e0 l\u2019accouchement (placenta accreta, h\u00e9morragies\u2026).<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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    Los partos se atienden en el hospital Quir\u00f3n de Pozuelo CCN 1328000076<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

    Suivi de la grossesse \u00e0 haut risque Fausses couches \u00e0 r\u00e9p\u00e9tition. Certains facteurs augmentent le risque de complications de la grossesse chez la m\u00e8re, chez le f\u0153tus ou chez les deux, et n\u00e9cessitent un suivi plus approfondi et sp\u00e9cialis\u00e9 pour r\u00e9duire ces risques. Parmi ces facteurs figurent: Ant\u00e9c\u00e9dents obst\u00e9tricaux et fausses couches \u00e0 r\u00e9p\u00e9tition : […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"site-sidebar-layout":"no-sidebar","site-content-layout":"page-builder","ast-site-content-layout":"full-width-container","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"disabled","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"disabled","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"enabled","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"editor_notices":[],"footnotes":""},"class_list":["post-2275","page","type-page","status-publish","hentry"],"yoast_head":"\nGrossesse \u00e0 haut risque - Docteure Isabel Santill\u00e1n Palencia<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.doctorasantillanpalencia.es\/fr\/grossesse-a-haut-risque\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Grossesse \u00e0 haut risque - Docteure Isabel Santill\u00e1n Palencia\" \/>\n<meta property=\"og:description\" content=\"Suivi de la grossesse \u00e0 haut risque Fausses couches \u00e0 r\u00e9p\u00e9tition. 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