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Systemic scleroderma and family planning: can you try to have a baby?

dr. Anna Litwińska

You can read this text in 3 min.

Systemic scleroderma and family planning: can you try to have a baby?

PantherMedia

Visit to a gynaecologist during pregnancy

Systemic scleroderma is a connective tissue disease that affects many organs in the body. What exactly is systemic scleroderma and what are the forms of treatment? Can women with the disease during their childbearing years get pregnant?

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Table of contents:

  1. Systemic scleroderma: what are the first symptoms and where to seek help?
  2. Systemic scleroderma and fertility and pregnancy
  3. Systemic scleroderma and the puerperium
  4. Summary

Systemic scleroderma is a connective tissue disease in which fibrosis of the organs and skin occurs. It is more common in women between 30 and 50 years of age. Due to the course of the disease, there are several variations that affect prognosis and type of treatment.

Systemic scleroderma: what are the first symptoms and where to seek help?

Like any disease, scleroderma comes in different forms. It can have a limited form, where the lesions are mainly on the skin, and over time the disease occupies the gastrointestinal and respiratory systems. The characteristic symptom is a hardening of the skin, initially in the facial area. The disease progresses slowly. In the generalised form, the course of the disease is more rapid, more severe. Skin lesions involve the face as well as the trunk, arms, thighs. Lungs, kidneys and heart may also be involved.

The skin changes are initially oedematous, followed by sclerosis and atrophy of the skin. The first symptom that occurs before the skin lesions appear is the so-called Raynaud's sign. This is the result of a circulatory disorder, which manifests itself initially by fading, followed by bruising and redness of the fingers. It appears in both forms of the disease.

Pregnancy, Systemic scleroderma, Treatment

Systemic scleroderma: can you get pregnant?, photo: panthermedia

At the onset of symptoms, it is worth consulting a rheumatologist who can confirm or rule out the disease. As there is no possible causal treatment, physical therapy is mainly used. In the case of organ involvement, the doctor may recommend immunosuppressive drugs, such as methotrexate or mycophenolate mofetil, which are designed to halt the progression of the disease.

Systemic scleroderma and fertility and pregnancy

Patients under the care of a rheumatologist and taking medication should plan for pregnancy because of the teratogenic effects of the drugs (toxic effects on the embryo or fetus), discuss a treatment plan for pre-conception, pregnancy and lactation.

In studies, patients with systemic scleroderma have the same risk of miscarriage as healthy women. The whole pregnancy may be monitored more frequently because of the higher risk of fetal stunting inside the uterus and the increased risk of preterm birth.

Pregnancy, Systemic scleroderma, Treatment

Systemic scleroderma: treatment in pregnancy, photo: panthermedia

Regarding the course of the disease, pregnancy does not affect the course of the disease, although cases of exacerbation of the disease have been described, especially in patients with systemic scleroderma involving the kidneys, lungs and heart. Pregnant patients are monitored more frequently to assess whether the disease is progressing. In patients with renal involvement, pregnancy may be contraindicated.

Constipation or hypertension may occur more frequently during pregnancy. Renal lesions may worsen, while Raynaud's sign is less frequent.

Systemic scleroderma and puerperium

The termination of pregnancy depends on the severity of the disease and the course of the pregnancy itself. There is no contraindication to caesarean section. Each case is considered individually.

In view of the use of medications in case of breastfeeding, it is necessary to discuss with the attending physician which medications can be used during breastfeeding or whether it is necessary to terminate lactation.

Pregnancy, Systemic scleroderma, Treatment

Systemic scleroderma: can you breastfeed?, photo: panthermedia

Summary

Systemic scleroderma is a disease that usually occurs in women after pregnancy, but it can appear even before planning to enlarge the family. Because of its course, the patient should be cared for by specialists: both a gynaecologist and a rheumatologist.