Document Detail

Pregnancy issues in scleroderma.
MedLine Citation:
PMID:  22155199     Owner:  NLM     Status:  Publisher    
Systemic sclerosis is a systemic, inflammatory, autoimmune disease affecting the skin and viscera, manifesting pathologically with microvascular lesions, perivascular infiltration by mononuclear cells and increased deposition of extracellular collagen. The rarity of the disease as well as its propensity to appear in the early 1940s, explain the low frequency of concurrent scleroderma and pregnancy. However, the marked female excess, as well as the trend for increasing maternal age due to social change and assisted reproductive technologies, renders heightened significance to issues of fertility, pregnancy course and pregnancy outcomes. In the past, scleroderma patients were thought to be at high risk for poor fetal and maternal outcome, but more current retrospective studies show that despite an increased frequency of prematurity and small for gestational age infants, overall maternal and neonatal survival is good. Hence, at present, with close monitoring and appropriate therapy most scleroderma patients can sustain a successful pregnancy. Therapy with hydroxychloroquine and low dose steroids as well as judicious use of intravenous immunoglobulins is permitted. Renal crisis remains the most dreaded complication of a scleroderma pregnancy and necessitates prompt institution of ACE inhibitor therapy despite its potential teratogenicity. In order minimize the risk for renal crisis, pregnancies should be avoided in rapidly progressive diffuse disease as such patients are at a greater risk for developing serious cardiopulmonary and renal problems early in the disease. This review shall focus on the bi-directional effects of scleroderma on fertility and pregnancy as well as on the management of pregnancy and delivery in the scleroderma patient.
Merav Lidar; Pnina Langevitz
Related Documents :
3120449 - Neuroendocrine regulation of anterior pituitary function in patients during and after m...
11084149 - Intercusp differences in enamel prism patterns in early and late stages of human tooth ...
20103799 - Clinical findings of multiple pregnancy with a complete hydatidiform mole and coexistin...
7651739 - Altered specificity of igf2 promoter imprinting during fetal development and onset of w...
3672279 - Hydatidiform mole with a coexistent live fetus. a case report.
16821639 - Primitive neuroectodermal tumor (pnet) of the brain diagnosed during pregnancy.
18565969 - Why don't we perform elective single embryo transfer? a qualitative study among ivf pat...
2205189 - Differentiation of monochorionic and dichorionic twin placentas by antenatal ultrasonic...
18982799 - Cord blood leptin levels in normal pregnancies, pregnancy induced hypertension and gest...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-3
Journal Detail:
Title:  Autoimmunity reviews     Volume:  -     ISSN:  1873-0183     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101128967     Medline TA:  Autoimmun Rev     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier B.V.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Estrogen metabolism and autoimmunity.
Next Document:  Disease modulation through the menstrual cycle.