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韦格纳肉芽肿病患者足月妊娠成功:病例报告及文献综述

Successful term pregnancy in a patient with Wegener's granulomatosis: case report and literature review.

作者信息

Koukoura Ourania, Mantas Nikitas, Linardakis Haralabos, Hajiioannou Jiannis, Sifakis Stavros

机构信息

Department of Obstetrics-Gynecology, University Hospital of Heraklion, Crete, Greece.

出版信息

Fertil Steril. 2008 Feb;89(2):457.e1-5. doi: 10.1016/j.fertnstert.2007.03.054. Epub 2007 May 22.

Abstract

OBJECTIVE

To present a case of successful term pregnancy in a patient with known Wegener's granulomatosis (WG).

DESIGN

Case report.

SETTING

University Hospital, Department of Obstetrics and Gynecology.

PATIENT(S): A 22-year-old primigravida pregnant woman with a history of WG diagnosed 5 years before.

INTERVENTION(S): The patient was treated with corticosteroids and azathioprine throughout pregnancy, and cyclophosphamide was added postpartum.

MAIN OUTCOME MEASURE(S): The disease was in partial remission at the onset of pregnancy, but two relapses occurred, at 33 weeks' gestation and 15 days after delivery. A 3150-g healthy boy was delivered at 37 weeks' gestation.

CONCLUSION(S): Pregnancy in patients with WG requires preconceptional planning, careful clinical management, and vigorous treatment of active disease. There are 36 cases of WG in pregnancy reported in the literature. Owing to this rarity, the management is individualized and the pregnancy outcome is variable. Antenatal management and therapeutic options are discussed and a short review of the literature is presented.

摘要

目的

报告一例已知患有韦格纳肉芽肿(WG)的患者成功足月妊娠的病例。

设计

病例报告。

地点

大学医院妇产科。

患者

一名22岁初产妇,5年前被诊断为WG。

干预措施

患者在整个孕期接受皮质类固醇和硫唑嘌呤治疗,产后加用环磷酰胺。

主要观察指标

疾病在妊娠开始时部分缓解,但发生了两次复发,分别在妊娠33周和分娩后15天。孕37周时分娩出一名体重3150克的健康男婴。

结论

WG患者妊娠需要孕前规划、仔细的临床管理以及对活动性疾病进行积极治疗。文献报道了36例妊娠合并WG的病例。由于这种情况罕见,管理是个体化的,妊娠结局也各不相同。本文讨论了产前管理和治疗选择,并对文献进行了简要综述。

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