Division of Rheumatology, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rua Dois de Dezembro, 131/702 Flamengo, Rio de Janeiro, RJ, 22220-040, Brazil.
Arch Gynecol Obstet. 2011 Mar;283 Suppl 1:61-5. doi: 10.1007/s00404-011-1859-0. Epub 2011 Feb 18.
Systemic lupus erythematosus (SLE) often requires administration of cyclophosphamide (CYC), especially for severe glomerulonephritis. As this disease usually affects young women in reproductive age, pregnancy, though not recommended may occur. The teratogenic effects of this drug make pregnancy prognosis and fetal survival indeterminate.
We reviewed retrospectively the medical records of five patients with SLE who received inadvertently CYC during pregnancy and analyzed fetal outcome.
All patients were exposed at the first trimester. Two patients suffered miscarriages, two went to full term and one presented premature labor.
In spite of potential successful pregnancies after CYC exposure, this drug has teratogenic effects and prescription must be avoided during the pregnancy period. At the same time, the occurrence of these reported unplanned pregnancies strengthen the need of improving patients' education on pregnancy risks during immunosuppressive treatment.
系统性红斑狼疮（SLE）常需使用环磷酰胺（CYC）治疗，尤其是在发生严重肾小球肾炎时。由于该病好发于育龄期年轻女性，故尽管不建议妊娠，但有时仍会意外妊娠。该药有致畸作用，因此妊娠结局和胎儿存活情况难以预测。
我们回顾性分析了 5 例 SLE 患者在妊娠期意外使用 CYC 的病历资料，并分析了胎儿结局。
所有患者均在妊娠早期暴露于 CYC。2 例患者发生流产，2 例患者足月产，1 例患者早产。
尽管在 CYC 暴露后可能会有成功妊娠，但该药有致畸作用，因此妊娠期间应避免使用。同时，这些意外妊娠的发生提示我们需要加强对接受免疫抑制治疗的患者进行妊娠风险教育。
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