Pravastatin to prevent recurrent fetal death in massive perivillous fibrin deposition of the placenta (MPFD).

Abstract

Massive perivillous fibrin deposition of the placenta (MPFD) or maternal floor infarction (MFI) is a serious condition associated with recurrent complications including fetal death and severe fetal growth restriction. There is no method to evaluate the risk of adverse outcome in subsequent pregnancies, or effective prevention. Recent observations suggest that MFI is characterized by an imbalance in angiogenic/anti-angiogenic factors in early pregnancy; therefore, determination of these biomarkers may identify the patient at risk for recurrence. We report the case of a pregnant woman with a history of four consecutive pregnancy losses, the last of which was affected by MFI. Abnormalities of the anti-angiogenic factor, sVEGFR-1, and soluble endoglin (sEng) were detected early in the index pregnancy, and treatment with pravastatin corrected the abnormalities. Treatment resulted in a live birth infant at 34 weeks of gestation who had normal biometric parameters and developmental milestones at the age of 2. This is the first reported successful use of pravastatin to reverse an angiogenic/anti-angiogenic imbalance and prevent fetal death.

• Authors: Tinnakorn Chaiworapongsa, Roberto Romero, Steven J Korzeniewski, Piya Chaemsaithong, Edgar Hernandez-Andrade, James H Segars, Alan H DeCherney, M Cathleen McCoy, Chong Jai Kim, Lami Yeo, Sonia S Hassan
• Journal: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (J Matern Fetal Neonatal Med) Vol. 29 Issue 6 Pg. 855-62 (Mar 2016) ISSN: 1476-4954 [Electronic] England
• PMID: 25893545 (Publication Type: Case Reports, Journal Article)

Chemical References

• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Immunoglobulins, Intravenous
• Vascular Endothelial Growth Factor Receptor-1
• Pravastatin

Topics

• Abortion, Habitual (blood, etiology, prevention & control)
• Adult
• Animals
• Female
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (pharmacology, therapeutic use)
• Immunoglobulins, Intravenous (therapeutic use)
• Placenta Diseases (blood, prevention & control)
• Pravastatin (pharmacology, therapeutic use)
• Pregnancy
• Vascular Endothelial Growth Factor Receptor-1 (blood)