Behçet's Disease and Pregnancy

Abstract

Objective. To describe the interplay between Behçet's disease (BD) and pregnancy.Methods. This retrospective study included 76 pregnancies in 46 patients fulfilling the international criteria for BD. The median age of the patients at the time of entry into the study was 28.4 years (interquartile range 22.8-30.9 years). Patients were used as their own historical controls to assess the incidence of BD flares during pregnancy and before or after pregnancy. Factors associated with the occurrence of complications during pregnancy were assessed.Results. Among the 76 pregnancies with BD analyzed, 27 (35.5%) were associated with worsening of the symptoms of BD flare; oral and genital ulcerations (78.4% and 67.6%, respectively) as well as ocular complications (32.4%) were the most frequent. The mean ؎ SD annual rates of BD flares were 0.49 ؎ 0.72 during pregnancy and 1.46 ؎ 2.42 during the nonobstetric period (P ‫؍‬ 0.018). The proportion of BD flares tended to be lower in patients treated with colchicine (27.9% versus 45.4% of patients not treated with colchicine; P ‫؍‬ 0.11). The overall rate of complications during pregnancy was 15.8%. The complications included miscarriage (5 patients), cesarean delivery (3 patients), medical termination of pregnancy (2 patients), hemolysis, elevated liver enzymes, and low platelets syndrome (1 patient), and immune thrombocytopenia (1 patient). There was a statistically significant association between a history of deep vein thrombosis in BD and the risk of obstetric complications (odds ratio 7.25, 95% confidence interval 1.21-43.46, P ‫؍‬ 0.029). Neither gestational age at delivery nor neonatal outcome was influenced by BD.Conclusion. The disease course in BD seems to improve during pregnancy, mostly in patients who are treated with colchicine. Pregnancy in patients with BD appears not to be associated with an increased rate of pregnancy-related complications.

The Evaluation of Anesthesiological Approach Accompanying Spinal Anesthesia Applied in a Pregnant Woman with Behçet Disease: A Case Report

“…Çalışmada kolşisin tedavisini sürdüren hastalarda hastalığın stabil kaldığı ve komplikasyonların da normal gebelerden fazla olmadığı belirtilmiştir. Kolşisin tedavisi almayan hastalarda ise santral sinir sistemi ve oküler lezyonlarda artış görülürken venöz tromboz hikayesi olan hastalarda obstetrik komplikasyonlarda özellikle de düşük insidansında artış tespit edilmiştir (6). Hastamızın gebelik tanısından sonra kendi isteğiyle kolşisin tedavisini bıraktığı saptandı.…”

“…BH'deki oral ülserler skar dokusuna neden olarak zor entübasyona neden olabilir (6). BH'nin tekrarlayan atakları sonucu orofarikste oluşan yoğun skar dokusunun önemli ölçüde entübasyon ve ventilasyon zorluğuna neden olduğunu gösteren olgu sunumları mevcuttur (9).…”

Management of Anesthesia in a Pregnant with Behçet’s Disease

“…It may cause intubation and ventilation difficulties due to the adhesions depending on ulcer healing scar tissue in especially oropharyngeal space. In addition intubation procedure, itself may lead to ulcer formation in the postoperative period 7 . The thyromental, sternomental distances, mouth opening, neck movements were all within normal range in the preoperative examination of our patient and we did not foresee any difficulties in airway control.…”

Behçet’s disease diagnosed by pregnancy-exacerbated genital ulcers

“…The influence of pregnancy on BD is controversial. In some cases, remissions or no significant influences have been reported [1][2][3], while exacerbation of BD has been reported in other cases [4][5][6]. In cases of worsening BD, mucocutaneous ulcerations seem to predominate during the second and third trimesters of pregnancy [3,5].…”