Pregnancy and vasculitis: A systematic review of the literature

Gatto, Mariele; Iaccarino, Leonardo; Canova, Mariagrazia; Zen, Margherita; Nalotto, Linda; Ramonda, Roberta; Punzi, Leonardo; Doria, Andrea

doi:10.1016/j.autrev.2011.11.019

Cited by 85 publications

(93 citation statements)

References 132 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Interestingly, of the 7 patients with obstetric complications, 5 had a history of venous thrombosis in BD prior to pregnancy (deep vein thrombosis [DVT], alone [n ϭ 2] or associated with dural sinus thrombosis [n ϭ 2]; pulmonary Comparison with series from the literature. Six series analyzing the interaction between BD and pregnancy have been published (10,(19)(20)(21)(22)26) and also were recently reviewed (29). By adding the data provided in the literature to those obtained in our study, a series of 279 pregnancies in 159 patients was available for analysis.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Behçet's Disease and Pregnancy

Noël

Wechsler

Nizard

et al. 2013

Arthritis & Rheumatism

View full text Add to dashboard Cite

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.

show abstract

Section: Resultsmentioning

confidence: 99%

“…We added relevant articles that were not identified using this strategy but were present in the reference list of other studies. In total, 6 series with more than 2 patients were analyzed (10,(19)(20)(21)(22)26), along with one recent review of the literature (29).…”

Section: Methodsmentioning

confidence: 99%

Behçet's Disease and Pregnancy

Noël

Wechsler

Nizard

et al. 2013

Arthritis & Rheumatism

View full text Add to dashboard Cite

show abstract

“…Отмечается высокий уровень преждевре-менных родов (15-20%), в некоторых случаях вну-триутробная задержка роста, низкая масса тела при рождении (10-25%), кесарево сечение более чем 35% случаев. Риск рецидива васкулита во время бе-ременности менее 5% [13,15,16]. Зарегистрировано несколько случаев появления TA во время послеро-дового периода [17].…”

Section: беременность у больных с системными первичными васкулитамиunclassified

“…Частота преждевременных родов при ГВ менее 10-30%, в отдельных случаях развива-ется внутриутробная задержка роста, масса тела ре-бенка при рождении низкая (10-25%) или высокая (до 40-50%), возможен преждевременный разрыв мембраны (до 30%). Согласно другим данным, ча-стота преэклампсии и потери плода может состав-лять до 25% [15,16,19]. Роды в 30-50% случаев про-исходят с помощью кесарева сечения.…”

Section: беременность у больных с системными первичными васкулитамиunclassified

See 1 more Smart Citation

Systemic primary vasculitis and pregnancy

Voznesenskaja¹,

Litvinenko²,

Blashkiv³

2015

Probl. reprod.

View full text Add to dashboard Cite

Классификация васкулитовТермин «васкулит» обозначает воспаление кро-веносных сосудов. Патологическим следствием та-кого воспаления является разрушение стенки сосу-да, видимое гистологически как фибриноидный не-кроз, отсюда и термин «некротический васкулит». Васкулит может быть локализован в одном органе или сосудистом русле и может быть клинически не-значительным, но чаще всего он генерализируется. Мышечные артерии могут развивать фокальные или сегментные поражения, которые могут представлять опасность для жизни. Фокальные поражения, затра-гивая часть стенки сосуда, могут привести к образо-ванию аневризмы и разрыву сосуда. Сегментные по-ражения влияют по всей окружности, они более рас-пространены и могут привести к стенозу или окклю-зии с дистальным инфарктом.Классификация васкулита -область споров в течение многих лет, конкретные критерии класси-фикации введены лишь относительно недавно. Оценка болезни в настоящее время подвергается дальнейшему пересмотру и доработке. Представлены данные литературы о течении беременности у женщин с системными первичными васкулитами. В настоящее время риск неблагоприятного исхода беременности для больных с системным первичным васкулитом таков: низкая материнская и плодовая смертность (<5-10%), преждевременные роды (до 40%). Таким образом, здоровье плода и матери зависит от активности заболевания и повреждения органов-мишеней во время беременности. Беременность у больных с васкулитом следует рассматривать как высокий риск, требующий тщательного планирования и регулярного мониторинга со стороны акушеров, терапевтов или ревматологов. Важно учитывать возраст матери и время, необходимое для достижения полной, а не частичной ремиссии заболевания. Беременность должна одобряться только тогда, когда васкулит находится в стадии стойкой ремиссии. The literature data about systemic primary vasculitis and pregnancy are presented. The pregnancy in patients with systemic primary vasculitis is characterized by low maternal and fetal mortality (<5-10%) and high premature delivery rate (up to 40%). Pregnancy in patients with vasculitis should be considered as high risk pregnancy requiring careful planning and regular monitoring by obstetricians, internists or rheumatologists who have experience in such special cases. It is important to take into account maternal age and the time required to achieve the total remission. Pregnancy should be approved only in sustained vasculitis remission or in vasculitis with minimal activity for at least 6 months without or with few organ damages.

show abstract

Pregnancy Outcomes Among Patients With Vasculitis

Clowse

Richeson

Pieper

et al. 2013

Arthritis Care & Research

View full text Add to dashboard Cite

Objective Pregnancy outcomes of patients with vasculitis are unknown, but are of great concern to patients and physicians. Through an online survey, this study assessed pregnancy outcomes among patients with vasculitis. Methods Participants in the Vasculitis Clinical Research Consortium Patient Contact Registry were invited to respond to an anonymous, internet-based survey that included questions about pregnancy outcomes, the timing of pregnancy relative to a diagnosis of vasculitis, and medication use. Results A total of 350 women and 113 men completed the survey. After a diagnosis of vasculitis, 74 pregnancies were reported by women and 18 conceptions were reported by men. The rate of pregnancy loss was higher among women who conceived after a diagnosis of vasculitis compared to those who conceived prior to diagnosis (33.8% versus 22.4%; P = 0.04). Among women, the rate of preterm births increased significantly for pregnancies conceived after a diagnosis of vasculitis relative to those conceived before diagnosis (23.3% versus 11.4%; P = 0.03). Only 18% of women reported worsening of vasculitis during pregnancy, but those who experienced increased vasculitis activity were more likely to deliver preterm. Exposure to cyclophosphamide or prednisone did not appear to impact pregnancy outcomes; however, the number of pregnancies among women taking these medications was small. Among the pregnancies conceived by men with vasculitis, the timing of diagnosis had no significant effect on the rate of pregnancy loss. Conclusion Women who conceived after a diagnosis of vasculitis had a higher rate of pregnancy loss than those who conceived prior to diagnosis. Vasculitis did not worsen during the majority of pregnancies conceived after diagnosis.

show abstract

Pregnancy and vasculitis: A systematic review of the literature

Cited by 85 publications

References 132 publications

Behçet's Disease and Pregnancy

Behçet's Disease and Pregnancy

Systemic primary vasculitis and pregnancy

Pregnancy Outcomes Among Patients With Vasculitis

Contact Info

Product

Resources

About