Chakravarty Eliza F
Division of Immunology and Rheumatology, Stanford University School of Medicine, 1000 Welch Road, Suite 203, Palo Alto, CA 94304, USA.
Int J Rheumatol. 2010;2010. doi: 10.1155/2010/287248. Epub 2010 Aug 11.
Systemic sclerosis (SSc) is a chronic autoimmune disorder characterized by progressive fibrosis of the skin and visceral tissues as well as a noninflammatory vasculopathy. Vascular disease in systemic sclerosis is a major cause of morbidity and mortality among nonpregnant patients with SSc and is even a bigger concern in the pregnant SSc patient, as the underlying vasculopathy may prevent the required hemodynamic changes necessary to support a growing pregnancy. Vascular manifestations including scleroderma renal crisis and pulmonary arterial hypertension should be considered relative contraindications against pregnancy due to the high associations of both maternal and fetal morbidity and mortality. In contrast, Raynaud's phenomenon may actually improve somewhat during pregnancy. Women with SSc who are considering a pregnancy or discover they are pregnant require evaluation for the presence and extent of underlying vasculopathy. In the absence of significant visceral vasculopathy, most women with SSc can expect to have reasonable pregnancy outcomes.
系统性硬化症（SSc）是一种慢性自身免疫性疾病，其特征为皮肤和内脏组织进行性纤维化以及非炎性血管病变。系统性硬化症中的血管疾病是导致非妊娠SSc患者发病和死亡的主要原因，而对于妊娠SSc患者而言更是一大担忧，因为潜在的血管病变可能会阻碍支持妊娠进展所需的血流动力学变化。由于母体和胎儿发病及死亡风险高度相关，包括硬皮病肾危象和肺动脉高压在内的血管表现应被视为妊娠的相对禁忌证。相比之下，雷诺现象在孕期实际上可能会有所改善。考虑妊娠或发现已怀孕的SSc女性需要评估潜在血管病变的存在情况和严重程度。在没有明显内脏血管病变的情况下，大多数SSc女性有望获得合理的妊娠结局。
