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Les recommandations sur la prise en charge thérapeutique des parturientes porteuses d'une thrombophilie constitutionnelle sont-elles appliquées au CHU de Grenoble ?

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(1)Les recommandations sur la prise en charge thérapeutique des parturientes porteuses d’une thrombophilie constitutionnelle sont-elles appliquées au CHU de Grenoble ? Florimond Chrétien. To cite this version: Florimond Chrétien. Les recommandations sur la prise en charge thérapeutique des parturientes porteuses d’une thrombophilie constitutionnelle sont-elles appliquées au CHU de Grenoble ?. Gynécologie et obstétrique. 2011. �dumas-00629309�. HAL Id: dumas-00629309 https://dumas.ccsd.cnrs.fr/dumas-00629309 Submitted on 5 Oct 2011. HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers.. L’archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d’enseignement et de recherche français ou étrangers, des laboratoires publics ou privés..

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(231)

(232) %. & &  d & B  F. *. A. B. &. *. A. A. (. *. S. @. B GBAAH. A GAFAH. A GAFAH. B GBAAH. *. *. &, &. 3[ ,' , + F). B GBAAH. @ G@TFMH. *.

(233)  , F). B GBAAH. *. *.  ,# & & " $ %F). A GAFAH. A GAFAH. D GBTFTHH. +$ & ,##F). A GAFAH. M GTLFSH. BD GTBF@H. d 2 M F). *. @. B. d 4 M F). *. J. B@. B GBAAH. B GBJFDH. A GAFAH. d 2 M F. *. B. *. d 4 M F. *. *. *. B GBAAH. A GAFAH. A GAFAH. d & @  F d & D  F +$ & #F) & &  d  " )F) % = 0% 0.  =% =: 

(234) * :$. = & . +$ & #F). -  ") F). /!+")/ . +% % 9 $$ % =9%9

(235) * @ABB. BMCD@.

(236) = " ), cB , " , #  ' R &  #F ".'   3 &.+$ & # ,& "." &  ) ,  >   ".+$ & ".  ,&  " & & #"  '. " , + 9 = " ,& & ,* ,F "  , +$ & #   , ,  & & #  " , -  " ") 9 = " ), c@ & , #  ' "# &.% %F BAAO  3 &. ,# , +$ & ,##  & " D(  & @TFMO &( @T

(237)   SBFJO , & DL

(238) 9 = " ,& & ,*,F BAAO & ,    ,# & TLFSO , +$ & ,##  BJFDO & #9 = LSFJO & F " & &    ,  )" M 9 = " ), cD , " , #  ' & &.% %F TBFDO . 3 &. ,# & ,& " )  BTFSO 6  ' ""  ,# , +$  & ,## & DDFDO ,&  " )  MMFSO , & DL

(239) 9 = " &E F   , &.& ," & $ %  &.% % # & 3 & ' )E  E9 = U@FDO & F " & &    ,  )" M 9. D9D *  %  0. _% 

(240) % =%  %  =% 0  +%i 0%

(241)  % %

(242) + $ +0%

(243) %  =% =% . *+,;. 

(244) 

(245) 

(246) 

(247) 5

(248) <<  1 @J  # & & ") 7. BB GJLFTH. # , , BAA )"). S GMDFMH. d & B@ DL

(249) "). S GBAAH. /!+")/ .  " @J , ,"  ,  &F JLFTO &. ""   ' &.% %  & & 9 MDFMO & ""*    ,# " ,") #"*," , ,7  B@  DL

(250) 9 +% % 9 $$ % =9%9

(251) * @ABB. BSCD@.

(252) = " ,,"  & & F  .# "#  ,# "  ,& " )9. D9J *  `% =% _:/%$%

(253) % =% . *+,:   6*7

(254) .  1 @J $ % ,& " )"). A GAFAH. $ % ,& " ,*,"). A GAFAH. /!+")/ .  # ,  ' , " @J , ' &.% % )  &F  . &#",, &  '   ,& " )  " ,*,   '"'  " ) ,' ,,"'9. +% % 9 $$ % =9%9

(255) * @ABB. BTCD@.

(256) (  

(257) 

(258)

(259) . J9B *   " & ".&  0 ,( " &  &  , &( ".) & , ".&

(260)  +`/%9 % 33F  " , ," & 3 E ( &." &  & .6  , ")  )F " , # " )  ,  ) " "& "' ,# "    ,"  , , " ,"9 :   &  ,  " , [ " , " , &  &9 =. ,F &  " , ) ".&

(261)  +`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

(262) * @ABB. BUCD@.

(263) ".# & "*F  '  ,  &    " # &. % % ,& " )  " ,*, , ,,    ,"9. J9@ * ' & " ,,"   &   33   "" & ,," ' & $ % & @BB ,  & ".&

(264)  +`/%  )  " 9+9:9 & /"  _ @AAT  #" @ABA9 =  @BB ,F @J  , &. ," ""F " 3   '  & &#",,  & "'F R , " 3 &.[ 9 =  @J F B   JF@O & 333    ' R &.% %   & " )  & ,*, & 3 & "," # ' # # 3 &"F     &. ) 9 @UF@O & ,   &  ' "# &.% % " " ( & "

(265) 9 BAAO &      & ," &.% %  BJFDO  & & 9 0 ), , " R &   " & , ' & &.% % # MMFSO & 3339  . &.& ," &.% %F MFDO      )    , ". &.   3 & ' )E C E9 M@FLO & , &  ),   & & 9 0 ), & , 3" ' & $ %  ,  F  6    3 & ' ")'9  "F DDFDO & , &  &    & &.% %  JLFTO  & & 9. J9D * = & " , ,, E &  J9D9B * =

(266) :

(267)

(268)  =: + Y =%

(269) % $$ = 

(270)

(271) % =% % %

(272) a % $$ %. 0 & , , 3 &  &   "" & , "

(273)  > &.  &  G

(274) 999H  @AAL  b# & " "& "' # ,*,  "b IBTK9  & 3  &. ,, , " +. +% % 9 $$ % =9%9

(275) * @ABB. @ACD@.

(276)  &

(277)  G+99

(278) H IBUK &E  ," ;      &(  6 ,, '"' &39 ,&F "

(279)  , ' *

(280)  

(281)   !!

(282) 

(283)   +

(284) 

(285) 

(286)     #+

(287)  &    & 9 = & ,"    & , ". "") 3  6 GH  @AAT  " R b "F ,"F  ,6F & ,)6   "") 3  6 * %#&*& ""  /&" GT %&Hb. I@AK. &3 &. & ,' , &  & ,"  ' &  3 & ' " $ %F  " ,, ,' ,  ,," # & ' )"  , #F ,# "" &. ," #"" "'  ,,6"E 3 &F .33 " , & ," & ,9 . ,' " & & "

(288)   # & 3  &9. J9D9@ *  %  0. _%   0  =

(289) :

(290)

(291)  =%

(292) 

(293) :0 

(294)    :Y % $$ = 

(295). %  & ' )*!$ &.% %F "

(296)  & ! #  =>3!!

(297) 

(298) =?<6

(299)  

(300) !!

(301) 

(302) 9 =  F "." & " )    , +$  & #9 = &   ' " +$  , , " ( ,"  &E(  (  IBJF BLF BM  BSK   F ".

(303)

(304) 

(305) G) > &

(306) 

(307)  & & &

(308) H  & , " "  ,#3   & ,  I@BK9 0  E +$ ,"; '.E +  , " ,  , & [   9 %  '  ".E,#F " ,  3 &.  ,    ' &. " E +$ , , "'F  ' "(# &. ,  ) &,   ,   ' ,3'F   & " & & "

(309) 9 3 ".+

(310) F &  & & @AADF &   & 

(311) #

(312) 6*7 "." &.+   , ) "'  " E +$ " & ".E,#  '   "  9  " ,& & ,*,F  ' ,     3 , +$ &( " "& &   #  " , -  " "). +% % 9 $$ % =9%9

(313) * @ABB. @BCD@.

(314) 9 0

(315)  & ' "" ,  # & '   , - ,  ,& & D   9 0 ,  ) &   & & "., &  # & ' & ,  ,#  # " &   '. &, E ( ," &   '9 3 ".) &.+$  ,  .,, E &  " R  , [ ," , & + 9 %  & ' +!, &.% %F "

(316)  &   ,#3 , +$ 

(317) !!

(318) &

(319)

(320) 

(321)

(322)  9  & "(# ' BAAO & , &  ),   33 >  ,# & +$ & ,## ,& " (   ' & SBFJO " ,# ".  , & DL

(323) 9 0 & ".E,#F @TFMO &  ,    " , +   '.  , ,   3 & ' , E  , &  ),9  ,# "  && ,'  &33F  ,# , +   & '   & 

(324) #

(325)   6*7 F  ' & ," )'9 = " ,& & ,*,F "

(326)  & "." &.  ,#3 , +$ ,  & & M T 9 =  &F   ' TLFSO & ,    "   ' " MMFSO &. "" ".  ,&   M 9 0 BJFDO & ,     , +$  & # ,  & 3 M F  .E,"' , ".E & 3 & ' ,,"9 3F  ,,P  &F  ' ," "# &# #  ,# ," ")9 0. & , & " & "  " , 3  E ,#   &&9 3F BAAO  3 &. ,# & " ,*,9 0 ,# ,*, ,& E &   '."" , [   ," &( " & & (  ,  & ".)  & ' &.% %  3   & ".# & " )IBDK9 0 & ".E,#F  " , +   & '   & 

(327)  #  

(328)     6*7  # & ' )'  ".F  ' .,, , [ "  , " , 6 3 &  ,#9  " ,& & ,*,F " &   +% % 9 $$ % =9%9

(329) * @ABB. @@CD@.

(330) R #   '  " & & " ,#  ( ' ".,," &. ) &F  "   ".&, &  " " ,3 ,, ' 9 %  '  " ' )'- &.% %F "

(331)  &   !    

(332) @

(333) !      

(334)

(335) 

(336)

(337)  9 =  &F TBFDO .  33 >  ,'   & " )  BTFSO '   ' ""   , +$ & ,##9  &33 & " ,  )  .E,"' , ,  &33F '   & " & ," &.% %  & " 3 & '9  " ,*,F "

(338)  & b  !  &#    =?<6  ;5A

(339) !

(340) 9 ,&F "" , ' " &  " & ,# [ & "' " '   ,9   &F BTFTO & , . 3 &. ,# ,'  TBF@O '  > & +$ & ,## & U@FDO ,  & ,  )" M 9 "   " " "  , &  E '  & & ,# "  #" & ' &.% %9  E,"' " &33 & ,  ) & " ) , & ' ,& &'9  " ,*,F  ,   ,  ) )""  # " & & "

(341)   '.""   , & BAAOF  ' , [ " ,  & ' R &.% % & " ,*,9 =  " F '" '  " # & 'F "

(342) F ".+

(343) F   ".F & " , &  &  "' ,& " )    & ,*,9 =  &F " ), ' R &.% % ,, BAAO &  6 , &  &  ,& " )  " ,*,9  " ), ' "#F  33   & TLFSO , " )  & BAAO , " ,*,9 %3F "   & LMFDO , " )  TBFDO , " ,*, & " ), ' & &.% %9  # &  )& & " ,# ' & " $ % " " # & 'F '   , ,, E 3 & ' ' , ,, " ,& &.E,  ' &.% %9 ,&  " & ".,," & & , ,,  6 ," & ,# , [ ))    & " )   ,"(   & ' & &.% %9 +% % 9 $$ % =9%9

(344) * @ABB. @DCD@.

(345) J9D9D *  08

(346) % =% 0. =% % =% 0 $ % +%i 0  :0   :=%. 0 " &  &    ' & "." & " ,," #F   &.% % .  #F '   " & " )  & " ,*,   '" '  " # & 'F  '  ) , ,, E & ' &'  ' & &#   & ," & BL JAO " " 6, & ,"F  '  [ &  , ,   &  , & ,   ,#3    9 3F  "  "# & 3 & ' & , & ".& &  9. J9D9J *  %  0. _% 

(347) % =%  %  =% 0   : 0%

(348)  % %

(349) + $ +0%

(350) %  =% =% .   '  & ' & F " & & "

(351)    , &  '9 % #F "" & ".+

(352) & @AAD ,  B!  &#

(353) C5#+

(354) -DD5-;D!E

(355) -028  9

(356)  !! F

(357) 

(358) 

(359)  << 9 =  &F   "# ' JLFTO & ,  , &. " &  ' MDFMO &. ""    ,# , , BAA )  B@  DL

(360) 9  "  #  "   & ,  # & ,  ) # & ,  ,"  6 )"   & &  3 &.#  " ,"  , #  ,  , & ' ," "#9 %  & ,"  &. &.& & F ".+

(361) #' %

(362)  

(363)  %! 

(364) # 

(365) ##

(366)      !!    !  &# 

(367)  #      <<      

(368)

(369) 

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