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Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
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[Systemic sclerosis and pregnancy].

L Josselin-Mahr1, B Carbonne, J Cabane

  • 1Service de médecine interne, hôpital Saint-Antoine, 184 rue du Faubourg-Saint-Antoine, Paris, France. laurence.josselin@sat.aphp.fr

La Revue De Medecine Interne
|July 17, 2010
PubMed
Summary
This summary is machine-generated.

Pregnancy in women with systemic sclerosis is usually favorable. However, severe disease or pulmonary hypertension indicates high risk, necessitating careful preconception counseling and monitoring for complications like prematurity and renal crisis.

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Area of Science:

  • Rheumatology
  • Obstetrics
  • Maternal-Fetal Medicine

Context:

  • Systemic sclerosis (SSc) in pregnancy is uncommon but generally has a positive outcome.
  • Preconception counseling is crucial for women with SSc planning pregnancy, involving teratogenic drug withdrawal and disease activity assessment.
  • Certain conditions like severe organ impairment, early diffuse SSc, and pulmonary hypertension are contraindications for pregnancy due to high maternal and fetal risks.

Purpose:

  • To review the current understanding of pregnancy outcomes in women with systemic sclerosis.
  • To identify risk factors and complications associated with SSc during pregnancy and the postpartum period.
  • To provide guidance on managing SSc in pregnant patients.

Summary:

  • The most common maternal complication during pregnancy is worsening gastroesophageal reflux. Severe complications include renal crisis and pulmonary hypertension flare-ups.
  • Adverse obstetric outcomes are primarily prematurity, often linked to intra-uterine growth restriction or preeclampsia, potentially due to SSc-associated vasculopathy or antiphospholipid antibodies.
  • Preventive treatments like aspirin or anticoagulants may benefit patients with a history of placental insufficiency. Uterine artery Doppler can predict vascular issues and guide treatment.

Impact:

  • Highlights the importance of preconception counseling and risk stratification for pregnant women with SSc.
  • Emphasizes the need for vigilant monitoring for specific complications such as renal crisis and pulmonary hypertension.
  • Suggests potential therapeutic strategies and the utility of Doppler studies for improved pregnancy management in SSc patients.
  • Underscores the need for multicenter prospective studies to refine predictors and management protocols for SSc in pregnancy.