Pregnancy and complicated familial Mediterranean fever

Abstract

Familial Mediterranean Fever (FMF) is an inherited disease, closely following the pattern of autosomal recessive inheritance. Amyloidosis is the most severe complication of the disease. The prevalence of pregnancy loss in women with FMF is considered to be high. There is no information to support the possibility of increase risk of late pregnancy complications or change in the natural course of the disease. Two cases are presented with complicated FMF. One case with proved amyloidosis and the second patient with ascites. Pregnancy and neonatal outcome were uneventful in both. No further deterioration in the systemic disease occurred.

Pregnancy Outcome in Women With Familial Mediterranean Fever: A Retrospective Analysis of 50 Cases With a 10-Year Experience

“…2 On the other hand, successful pregnancy outcomes with renal amyloidosis were also reported. 6,7 In our study, we encountered three cases of renal amyloidosis, one out three had deterioration in renal function during pregnancy, however, the other two reported well. In this perspective, with close follow-up and consultation on maternal and perinatal morbidity and mortality to the couple, conception may be advisable.…”

The Impact of Familial Mediterranean Fever on Women's Health

“…Some authors have suggested a higher risk of growth restriction, 43 although larger studies have not born this out. 43,45,46,51 At present, there is no indication for additional growth scans or antenatal monitoring unless other clinical issues arise. Data regarding preeclampsia and FMF are sparse.…”

“…42,45,48 The rate of miscarriage was equally high for women who stopped colchicine therapy at the beginning of pregnancy. 42 Ben-Chetrit and Levy, in unpublished data, found the rate of pregnancy loss in women with and without FMF to be "almost comparable."…”

“…44 Colchicine therapy during pregnancy decreases attack frequency and severity, leading to improved pregnancy outcomes. 42,[45][46][47] The dosage of colchicine may need to be adjusted during pregnancy to maintain adequate control.…”

“…Treatment for acute attacks in pregnancy is similar to the nonpregnant patient, although nonsteroidal anti-inflammatory drugs are generally avoided in late pregnancy due to concerns of fetal ductal constriction. 40,43,45 If the fetal status is nonreassuring even after resuscitative measures, then delivery must be considered. At this time, there are no specific recommendations for mode of delivery in women with FMF.…”