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Pregnancy in systemic sclerosis.

I Miniati1, S Guiducci, F Mecacci

  • 1Department of Biomedicine, Section of Rheumatology, AOUC Florence, viale Pieraccini 18, 50139 Florence, Italy. irene.miniati@unifi.it

Rheumatology (Oxford, England)
|June 25, 2008
PubMed
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Pregnant patients with Systemic Sclerosis (SSc) can achieve successful pregnancies with careful planning and monitoring. While preterm births are more common, miscarriage and survival rates are similar to healthy individuals.

Area of Science:

  • Rheumatology
  • Maternal-Fetal Medicine
  • Obstetrics

Background:

  • Historically, pregnancy in Systemic Sclerosis (SSc) patients was considered high-risk.
  • Recent advancements in management have improved outcomes for pregnant SSc patients.

Purpose of the Study:

  • To review the current understanding of pregnancy outcomes in SSc patients.
  • To outline strategies for optimizing maternal and fetal health in SSc pregnancies.

Main Methods:

  • Retrospective analysis of pregnancy outcomes in SSc patients.
  • Review of current therapeutic guidelines for managing SSc during pregnancy.

Main Results:

  • Increased frequency of preterm births and small-for-gestational-age infants observed.

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  • Miscarriage rates and neonatal survival rates comparable to healthy controls.
  • Scleroderma renal crisis is a critical complication, necessitating ACE inhibitor use despite contraindications.

    • Conclusions:

    • Pregnancy in SSc requires careful planning, disease stabilization before conception, and close monitoring.
    • Certain medications like Hydroxychloroquine (HCQ), IVIg, and low-dose steroids can be used safely.
    • Multidisciplinary team approach is crucial for managing SSc pregnancies and minimizing risks.