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Rheumatology 2008 47(Supplement 3):iii13-iii15; doi:10.1093/rheumatology/ken152
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Pre-pregnancy counselling of patients with vasculitis

A. Doria1, G. Bajocchi2, M. Tonon1 and C. Salvarani2

1Division of Rheumatology, Department of Medical and Surgical Sciences, University of Padova, Padova and 2Rheumatology Unit Arcispedale S. Maria Nuova, Reggio Emilia, Italy.

Correspondence to: A. Doria, Division of Rheumatology, University of Padova, Via Giustiniani, 2, 35128 Padova, Italy. E-mail: adoria{at}unipd.it


  Abstract

The knowledge about the risk of pregnancy in vasculitides mostly derives from single case reports or at best from retrospective studies with all the caveats that these observations include. Primary systemic vasculitides are uncommon, encompassing a broad spectrum of severity, from mild to life-threatening manifestations and with different natural histories, from self-limiting to relapsing or chronic active disease. The treatments require a cautious use of immunosuppressants tailored to each specific condition. Furthermore, most of the cytotoxic drugs necessary to treat vasculitis act by modifying the cell cycle and cell differentiation, biological effects that are particularly hazardous for the foetus. In order to have an uncomplicated pregnancy, conception should be planned when the disease is inactive. Moreover, organ failure or damage, due to previous disease activity, must also be taken into account since it can lead to adverse obstetrical and fetal outcomes.

KEY WORDS: Risk, Pregnancy, Systemic vasculitis, Cytotoxic drugs

Submitted 14 March 2008; Accepted 27 March 2008


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