Feto-maternal outcome in patients with systemic sclerosis

Aim of the workTo study the maternal and fetal outcomes in pregnant women with systemic sclerosis (SSc) and to analyze the possible associated risk factors.Patients and methodsTwenty pregnant women with SSc and 20 age-matched low risk pregnant women were recruited in this study. Patients were evaluated clinically and in the laboratory at the entry of the study and at monthly intervals. Different pregnancy outcome measures were studied. Impacts of pregnancy on scleroderma patients were determined during and after pregnancy. The possible associated risk factors were analyzed.ResultsTwenty SSc pregnant women were recruited in this study with a mean age of 29.6 ± 3. Eight (40%) of them had limited SSc, and 12 (60%) had diffuse type. Pregnancies were complicated by maternal flare of the underlying disease in six (30%) pregnant patients. Six patients (30%) had preterm labor. Four patients (20%) had small for gestational age (SGA) infants, two of them (10%) had intra uterine growth retardation (IUGR). Two patients (10%), with diffuse type, fulfilled the criteria of antiphospholipid syndrome (APS) but unfortunately the pregnancy ended in miscarriage. Eight (40%) full-term infants were born two of them had SGA, two cases with miscarriage due to renal crisis and pulmonary hypertension and another two cases with intra uterine fetal death (IUFD). The live birth rate was 14/20 (70%) in the SSc group.ConclusionWomen with SSc can safely have healthy pregnancies if pregnancy is planned when the disease is stable and managed by a multidisciplinary team during pregnancy.