Scleroderma and Pregnancy

Younker, Dirk; Harrison, B.

doi:10.1093/bja/57.11.1136

Cited by 32 publications

(14 citation statements)

References 15 publications

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“…Prior to the widespread use of angiotensin-converting enzyme (ACE) inhibitors, renal crisis was one of the leading causes of mortality. Many of the perinatal deaths reported among SSc patients involved scleroderma renal crisis [7–10]. Even in more recent series, episodes of renal crisis during pregnancy were reported.…”

Section: Scleroderma Renal Crisismentioning

confidence: 99%

Vascular Complications of Systemic Sclerosis during Pregnancy

Chakravarty

2010

International Journal of Rheumatology

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Systemic sclerosis (SSc) is a chronic autoimmune disorder characterized by progressive fibrosis of the skin and visceral tissues as well as a noninflammatory vasculopathy. Vascular disease in systemic sclerosis is a major cause of morbidity and mortality among nonpregnant patients with SSc and is even a bigger concern in the pregnant SSc patient, as the underlying vasculopathy may prevent the required hemodynamic changes necessary to support a growing pregnancy. Vascular manifestations including scleroderma renal crisis and pulmonary arterial hypertension should be considered relative contraindications against pregnancy due to the high associations of both maternal and fetal morbidity and mortality. In contrast, Raynaud's phenomenon may actually improve somewhat during pregnancy. Women with SSc who are considering a pregnancy or discover they are pregnant require evaluation for the presence and extent of underlying vasculopathy. In the absence of significant visceral vasculopathy, most women with SSc can expect to have reasonable pregnancy outcomes.

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Section: Scleroderma Renal Crisismentioning

confidence: 99%

Vascular Complications of Systemic Sclerosis during Pregnancy

Chakravarty

2010

International Journal of Rheumatology

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“…Gastrointestinal bleeding and anemia may occur secondary to angiodysplasia of the upper gastrointestinal tract 16. Malabsorption syndromes are also common, and can lead to electrolyte imbalance, hypokalemia, hypoprothrombinemia, osteomalacia, and protein deficiency 15–17. Chronic malabsoption of vitamin B12 has resulted in subacute degeneration of the spinal cord 18.…”

Section: Organ Involvement In Systemic Sclerosismentioning

confidence: 99%

“…It is a particularly high cause of mortality in affected pregnant patients 3. The patient may develop a “scleroderma renal crisis”, characterized by acute oliguric renal failure, hypertension (which may progress to malignant hypertension), and proteinuria 14–17,23. They may also develop microangiopathic hemolytic anemia 3…”

Section: Organ Involvement In Systemic Sclerosismentioning

confidence: 99%

“…This may be the initial presentation,2,6,17 ranging from vascular hyperactivity to complete vascular obliteration. 26 It may be triggered by exposure to cold, vibration, and stress 23…”

Section: Organ Involvement In Systemic Sclerosismentioning

confidence: 99%

“…In up to 70% of patients, the face may become pinched, with atrophied nasal alae and restricted mouth opening as a result of soft tissue shrinkage 1,17,20,23,29. There may also be limited neck extension due to thickened inelastic skin 14.…”

Section: Organ Involvement In Systemic Sclerosismentioning

confidence: 99%

See 2 more Smart Citations

The role of regional and neuroaxial anesthesia in patients with systemic sclerosis

Dempsey

Rowell²,

McRobert

2011

LRA

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Systemic sclerosis (SSc), previously known as progressive systemic sclerosis, is a form of scleroderma and a multisystem connective tissue disease which can impact on every aspect of anesthetic care, especially airway management. In this review we outline clinical manifestations and current medical treatment of the disease, and general principles of anesthetizing these patients. We focus on the role of regional anesthesia, including neuroaxial anesthesia, which may serve as a safe alternative to general anesthesia but can be technically challenging. We address concerns regarding abnormal responses to local anesthesia which have previously been reported in patients with SSc, and explore future developments in technology and pharmacology, which may enable regional anesthesia to be performed more successfully and with fewer complications.

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A Scleroderma Patient Inquires About Pregnancy

Steen¹

2011

Case Studies in Systemic Sclerosis

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Scleroderma and Pregnancy

Cited by 32 publications

References 15 publications

Vascular Complications of Systemic Sclerosis during Pregnancy

Vascular Complications of Systemic Sclerosis during Pregnancy

The role of regional and neuroaxial anesthesia in patients with systemic sclerosis

A Scleroderma Patient Inquires About Pregnancy

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