Guidelines for the management of pregnancy in women with cystic fibrosis

Abstract

Women with cystic fibrosis (CF) now regularly survive into their reproductive years in good health and wish to have a baby. Many pregnancies have been reported in the literature and it is clear that whilst the outcome for the baby is generally good and some mothers do very well, others find either their CF complicates the pregnancy or is adversely affected by the pregnancy. For some, pregnancy may only become possible after transplantation. Optimal treatment of all aspects of CF needs to be maintained from the preconceptual period until after the baby is born. Clinicians must be prepared to modify their treatment to accommodate the changing physiology during pregnancy and to be aware of changing prescribing before conception, during pregnancy, after birth and during breast feeding. This supplement offers consensus guidelines based on review of the literature and experience of paediatricians, adult and transplant physicians, and nurses, physiotherapists, dietitians, pharmacists and psychologists experienced in CF and anaesthetist and obstetricians with experience of CF pregnancy. It is hoped they will provide practical guidelines helpful to the multidisciplinary CF teams caring for pregnant women with CF.

Guía de Práctica Clínica para el manejo nutricional de personas con Fibrosis Quística (GPC-FQ)

“…El seguimiento debe llevarse a cabo por un equipo coordinado con conocimiento y experiencia en FQ. Se debe prestar especial atención a la ganancia de peso, especialmente durante el último trimestre del embarazo 73 .…”

“…Se debe tener en cuenta la salud del bebé y el efecto de éste sobre la madre con FQ. Existe relativamente poca información sobre la evolución de las madres y casi ninguna acerca de la de los recién nacidos más allá del período neonatal 73 .…”

Adult cystic fibrosis care in the 21st century

“…Successful pregnancy is increasingly common in adult CF females [64]. It requires careful planning to ensure good outcomes.…”

Mise à niveau d’un secteur de soins pharmaceutiques : le cas de la fibrose kystique

“…ont publié en 2005 un consensus européen sur la prise en charge de la fibrose kystique, où on reconnait l'importance d'avoir un pharmacien décentralisé au sein de l'équipe traitante sans en préciser le rôle 11 . Edenborough et coll., dans les lignes directrices de prise en charge des femmes enceintes atteintes de fibrose kystique publiées en 2007, soulignent l'importance du pharmacien dans l'équipe interdisciplinaire 12 . Au Canada, un groupe consultatif en matière de politiques sur l'accès aux médicaments pour la fibrose kystique a été mis sur pied en 2012 13 , et Fibrose kystique Canada a publié un guide à l'intention des familles en soulignant le rôle du pharmacien dans ce contexte 14 .…”