title: Contraception, pregnancy and rare respiratory diseases.
abstract: Three percent of rare diseases are pneumopathies. Improvements in survival and quality of life have led to a new situation where patients with rare respiratory diseases want to plan their reproductive lives. The intention of this review is to present the experience accumulated in the field of the reproductive health of these women. In several rare respiratory diseases, a genetic base has been identified. The combination of preimplantation genetic diagnosis, assisted reproduction and molecular biology techniques enable embryos to be studied genetically before being transplanted into the uterus. Therefore, the risk for transmitting a certain disease or chromosome alteration may be avoided in high-risk couples, and prenatal diagnoses may be done by chorionic villus sampling or amniocentesis. As a general rule, contraceptive methods should be personalized by evaluating the general state of female patients as well as their possibilities for pregnancy, complications and the future possibility of lung transplantation. In lymphangioleiomyomatosis and primary pulmonary hypertension, pregnancy is considered a contraindication. In the former, there is a very high risk for pneumothorax and loss of lung function. In the latter, mortality reaches 33%. In cystic fibrosis, it is estimated that each year 4% of patients become pregnant and there is no observed loss in lung function. There are special circumstances in childbirth that should be considered as well as specific anesthesia risks. The present review suggests that the decision about contraceptive methods, pregnancy as a contraindication or conditions for managing a pregnancy should be both individualized and multidisciplinary.
authors: Servicio de Neumología, Hospital Universitario Arnau de Vilanova, Lleida, Spain. beat1135@gmail.com
authors: Beatriz
authors: B
authors: Lara
authors: Inocencia
authors: I
authors: Fornet
authors: María
authors: M
authors: Goya
authors: Francisco
authors: F
authors: López
authors: José Ramón
authors: JR
authors: De Miguel
authors: María
authors: M
authors: Molina
authors: Pilar
authors: P
authors: Morales
authors: Esther
authors: E
authors: Quintana
authors: Sabina
authors: S
authors: Salicrú
authors: Elena
authors: E
authors: Suárez
authors: Piedad
authors: P
authors: Usetti
authors: Felipe
authors: F
authors: Zurbano
mesh_terms: D002585:Cesarean Section; D003267:Contraception / Q000379:methods; D003278:Contraceptives, Oral, Hormonal; D000075202:Contraindications; D003550:Cystic Fibrosis / Q000235:genetics / Q000517:prevention & control; D005260:Female; D005817:Genetic Counseling; D006801:Humans; D006976:Hypertension, Pulmonary / Q000628:therapy; D007231:Infant, Newborn; D007751:Labor, Induced; D008017:Life Expectancy; D016040:Lung Transplantation; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000235:genetics / Q000517:prevention & control / Q000628:therapy; D018566:Pregnancy, High-Risk; D019836:Preimplantation Diagnosis; D011295:Prenatal Care; D027724:Reproductive Techniques, Assisted; D012140:Respiratory Tract Diseases / Q000235:genetics / Q000503:physiopathology* / Q000601:surgery; D012306:Risk; D017741:Survivors
chemical_list: D003278:Contraceptives, Oral, Hormonal