Pregnancy

Abstract

Systemic sclerosis (scleroderma, SSc) is a systemic connective tissue disease that occurs in women three to five times more frequently than men. Clinical manifestations include fibrosis of the skin and visceral organs, as well as a noninflammatory, progressive vasculopathy. With the mean age of onset of SSc symptoms in the early 40s, almost half of women with this illness have the potential of becoming pregnant after the onset of symptoms. Years ago, most women would have completed their pregnancies prior to this age, but more recently, women are frequently delaying pregnancy. Thus, there is an increased likelihood for a concurrent pregnancy in women who develop SSc early in their adult life. The interrelationships of SSc and pregnancy are important from both the effects of SSc on pregnancy and the effects pregnancy may have on underlying maternal SSc. This chapter reviews the literature relating to fertility, pregnancy, and pregnancy outcomes in women with SSc. The management of these high-risk pregnancies, the effects of pregnancy on SSc problems, and recommendations for managing medications in the pregnant SSc patient will be discussed. The use of this information in planned, well-supervised pregnancies should increase the likelihood of both the success of the pregnancy and the birth of a healthy infant and the stability of the mother.