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Tuberous sclerosis in pregnancy.

B M Petrikovsky1, A M Vintzileos, S B Cassidy

  • 1State University of New York, Stony Brook, Department of Obstetrics and Gynecology 11794.

American Journal of Perinatology
|April 1, 1990
PubMed
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Tuberous sclerosis during pregnancy is rare and can lead to serious complications, particularly with kidney involvement. Early renal evaluation is crucial for managing risks in pregnant patients with this condition.

Area of Science:

  • Obstetrics and Gynecology
  • Medical Genetics
  • Nephrology

Background:

  • Tuberous sclerosis is an autosomal dominant disorder characterized by hamartoma formation affecting multiple organs.
  • Historically, typical presentations included seizures, intellectual disability, and facial angiofibromas, but expression variability is now recognized.
  • Pregnancy cases are rare, with limited data on maternal and fetal outcomes.

Observation:

  • This study details two additional cases of tuberous sclerosis in pregnancy.
  • The first case involved significant renal complications: bleeding into a renal cyst, renal failure, preeclampsia, and severe intrauterine growth retardation.
  • The second case presented with preterm premature rupture of membranes and preterm labor.

Findings:

  • Renal involvement emerged as the most critical prognostic factor in pregnancies complicated by tuberous sclerosis.

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  • Reported complications in tuberous sclerosis pregnancies include acute intra-abdominal bleeding, renal failure, severe preeclampsia, and intrauterine growth restriction.
  • Outcomes varied, with some cases experiencing severe maternal and fetal complications.

    • Implications:

    • Preconceptional counseling and thorough renal evaluation are essential for pregnant patients with tuberous sclerosis.
    • Identifying and managing renal complications proactively can potentially improve maternal and fetal outcomes.
    • Further research is needed to fully understand the risks and optimal management strategies for tuberous sclerosis during pregnancy.