[Scleroderma and pregnancy].
- The frequency of concurrent scleroderma and pregnancy is low because scleroderma is a rare connective-tissue disease and the mean age of symptom onset is in the early 40s. The reciprocal influence of pregnancy and scleroderma and management of pregnancy are the purpose of this review. Current knowledge and key points. - There is no increase in infertility in women with scleroderma. The effect of pregnancy on scleroderma is a greater risk of renal crisis, especially when scleroderma is evolutive, diffuse and recent. Conversely, pregnancy is characterized by prematurity and small full-term infants because scleroderma induce placentar vascular abnormalities. There is no increase in miscarriages and spontaneous abortions. The pregnant scleroderma patient is a potential anaesthetic challenge because of physical difficulties and visceral involvement. Future and projects. - Planning of pregnancy and follow-up by a multidisciplinary experienced team in high risk pregnancies are guarantees for successful pregnancies. Future research will try to determine the role of microchimerism in scleroderma physiopathology and specify placental findings in order to ameliorate the obstetrical prognosis.
Rabhi
Monsef
M
Service de Médecine Interne, Hôpital Saint-Antoine, 184, rue du Faubourg-Saint-Antoine, 75571 Paris Cedex 12, France.
Tiev
Kiet Phuong
KP
Genereau
Thierry
T
Cabane
Jean
J
D058186:Acute Kidney Injury / Q000209:etiology* / Q000401:mortality; D000328:Adult; D002678:Chimera; D000075202:Contraindications; D004358:Drug Therapy; D005260:Female; D005298:Fertility; D006801:Humans; D008428:Maternal Mortality; D010922:Placenta Diseases / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality; D012595:Scleroderma, Systemic / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D012720:Severity of Illness Index