Systemic Vasculitides: Current Status and Perspectives by Franco Dammacco Domenico Ribatti & Angelo Vacca

Author:Franco Dammacco, Domenico Ribatti & Angelo Vacca
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Systemic Vasculitides (SV) are rare diseases and, unlike other rheumatic diseases, do not preferentially affect women during their childbearing age (with the exception of Takayasu arteritis and Behcet’s disease), so that pregnancy in these patients is still an uncommon event. In the last decades, the improvement in diagnosis and management of SV determined a reduction in mortality and morbidity of these patients; the consequent improvement in quality of life could include for young women the possibility to carry out one or more pregnancies. Gestation in women with vasculitis requires a constant and careful management by Rheumatologists/Internists and Obstetricians, Neonatologists and also other medical specialties (i.e. nephrology) when indicated [1] to increase the possibilities of success. In fact, pregnancy-related modifications (immunological, cardiovascular and thrombophilic) can affect the course of the disease and the pregnancy outcome.

Preconception counseling is crucial for any patient with connective tissue disease in order to estimate the chance of both fetal and maternal problems, related to either disease activity or organ involvement, as contraindication to pregnancy. In particular, special attention should be given to cardiac or renal impairment, arterial hypertension, refractory asthma and tracheal stenosis, which can affect the course of the pregnancy and/or delivery [2]. Careful consideration must also be given to other common epidemiological risk factors that are relevant to any pregnancy as age, tobacco use, low or excess weight, arterial hypertension, diabetes mellitus, previous obstetric history.

When talking about her productive plans, any patient will ask questions concerning their health and offsprings’ health. Therefore, the following issues must be discussed with patients who desire a pregnancy:Disease activity during pregnancy and post-partum period and the possible effects on fetal outcome;

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