title: Pregnancy complicating Wegener's granulomatosis.
abstract: Pregnancy associated with Wegener's granulomatosis is rare. Therapeutic options are limited. There is a paucity of published literature to guide clinical decision-making in these complex patients. Two cases are presented. Firstly, a 33-year-old woman with generalized Wegener's in remission and off all medications presented with a flare in the third trimester with haemoptysis, raised C-reactive protein and c-anti-neutrophilic cytoplasmic antibody (c-ANCA) levels. Her care was complicated by florid steroid-induced psychosis. With deteriorating disease control, she was treated with pulsed-intravenous cyclophosphamide with a good response. She delivered a healthy baby at 38 weeks. She had a severe postpartum flare. Secondly, a 37-year-old woman with limited Wegener's in remission for the last two years and off all treatment became pregnant after pre-conception counselling. A normal baby was delivered at term. An exhaustive review of all published literature on Wegener's activity in pregnancy is presented along with therapeutic options and recommendations.
authors: North Shore Hospital, Waitemata District Health Board , Auckland , New Zealand.
authors: May Ching
authors: MC
authors: Soh
authors: North Shore Hospital , North Shore City, Auckland , New Zealand.
authors: Hamish H
authors: HH
authors: Hart
authors: National Women's Health, Auckland City Hospital, Auckland District Health Board , Auckland , New Zealand.
authors: Eileen
authors: E
authors: Bass
authors: National Women's Health, Auckland City Hospital, Auckland District Health Board , Auckland , New Zealand.
authors: Lucille
authors: L
authors: Wilkinson
keywords: Wegener's granulomatosis; cyclophosphamide; haemoptysis; pregnancy; steroid-induced psychosis