Pregnancy in myositis and scleroderma. (April 2020)

• Record Type: Journal Article
• Authors: Munira, Sirajum; Christopher-Stine, Lisa
• Is Part Of: Best practice & research. Volume 64(2020)
• Page Start: 59
• Page End: 67
• Publication Date: 2020-04
• Subjects: Myositis -- Idiopathic inflammatory myopathies -- Scleroderma -- Pregnancy -- Reproductive health; Gynecology -- Periodicals; Obstetrics -- Periodicals; Genital Diseases, Female; Obstetrics; Gynecology; Obstetrics; Periodicals; 618.05
• DOI: 10.1016/j.bpobgyn.2019.10.004
• Languages: English
• ISSNs: 1521-6934

Abstract

Abstract: Myositis and scleroderma are both rare autoimmune diseases with female predominance and often occur before and during reproductive years. The rarity of diseases explains the low frequency of concurrent disease and pregnancy. Like other autoimmune diseases, myositis and scleroderma may be more active during pregnancy as well. To date, many patients with myositis and scleroderma can have favorable pregnancy outcomes with careful management. This chapter provides a current overview of pregnancy outcomes in myositis and scleroderma. A major theme that appears to have emerged across these inflammatory diseases is that active maternal disease during pregnancy is associated with adverse pregnancy outcomes, and thus, personalized management is necessary depending on the disease state and comorbidities. Highlights: Active disease is associated with poor pregnancy outcomes in myositis and scleroderma patients; hence, good control of disease is critically important for optimum pregnancy outcomes. There is no significant maternal complication in pregnant patients with myositis. IVIG and glucocorticoid are the mainstays of treatment of myositis in pregnant patients. Pregnancy is overall associated with a global stability of scleroderma. Some patients are exposed to a risk of worsening of the disease, especially for vital organ involvements such as the lungs, the heart, and the kidneys. Pregnancy-related Scleroderma renal crisis necessitates ACE inhibitor therapy despite potential teratogenicity.