[Sarcoidosis and pregnancy]

If well managed, pregnancy in women with sarcoidosis is usually carried to term with no problem, excepting rare contraindications. There is no specific risk for the embryo-fetus. Fertility is unchanged. Pregnancy can be contraindicated in case of respiratory failure due to heart failure or central nervous system disorders. A vital capacity less than 100 ml or pulmonary hypertension contraindicate pregnancy. Pregnancy should be discouraged during a period of active disease progression., but pregnancy in itself does not aggravate sarcoidosis. A flare up 3 to 6 months after delivery is not unusual. Therapeutic indications are the same as outside pregnancy, corticosteroid therapy being the only proven treatment during this period. Methotrexate and antimalaria drugs are contraindicated. Methotrexate, even with low weekly doses has a teratogenic effect, particularly between 6 and 8 weeks gestation. Likewise, congenital anomalies have been described with antimalaria drugs although the risk is less than with methotrexate.