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[皮肌炎和多发性肌炎中的妊娠]

[Pregnancy in dermatomyositis and polymyositis].

作者信息

Kaddour Neila, Snoussi Mouna, Marzouk Sameh, Frikha Faten, Jallouli Moez, Frigui Makram, Masmoudi Hatem, Guermazi Mohamed, Bahloul Zouhir

机构信息

Service de medecine interne, Universitd de Sfax, Sfax, Tunisie.

出版信息

Tunis Med. 2012 Aug-Sep;90(8-9):606-12.

Abstract

AIM

To determine the incidence of pregnancies during the inflammatory myopathy (IM), its influence on this disease and the influence of IM on the pregnancy's outcome.

METHODS

From 1979 to 2007 we have collected retrospectively 67cases of IM (53 women and 14 men) in the department of internal medicine CHU Hedi Chaker of Sfax (Tunisia). Diagnosis criteria were those and Peter. We have included pregnancies occurring after diagnosis of DM or PM and cases of IM occurring during pregnancy or postpartum.

RESULTS

Five women (4DM and PM), average age 30.6 years (range 26 - 41 years) conducted 10 pregnancies (9.4%). The fertility rate is 2 pregnancies per patient. Nine pregnancies occurred after the diagnosis of myositis in 4 women. IM was inactive at conception in all this cas.No flare-up in IM has been noted during these pregnancies. The DM was revealed to the 10th day post-partum in one patient. Therapeutic interruption of pregnancy was needed in 3 cases. 4 pregnancies were completed without incident and resulted in the birth of healthy newborns. Foetal complications were observed in the other two pregnancies occurring in one patient who also presents an APS associated with DM. It was a foetal death in utero and premature delivery of a newborn who died in 3rd day after birth.

CONCLUSION

Pregnancy in the MI is rare. Its influence on the activity of the disease is variable, both during the pregnancy than postpartum. The foetal prognosis is good when the the disease is in remission. However foetal complications are important in case of active IM.

摘要

目的

确定炎性肌病(IM)患者妊娠的发生率、其对该病的影响以及IM对妊娠结局的影响。

方法

1979年至2007年,我们回顾性收集了突尼斯斯法克斯市赫迪·查克大学医院内科的67例IM患者(53名女性和14名男性)。诊断标准依据彼得等人的标准。我们纳入了诊断为皮肌炎(DM)或多发性肌炎(PM)后发生的妊娠,以及妊娠期间或产后发生的IM病例。

结果

5名女性(4例DM和PM),平均年龄30.6岁(范围26 - 41岁),共妊娠10次(9.4%)。每位患者的生育率为2次妊娠。4名女性在诊断为肌炎后妊娠9次。所有这些病例在受孕时IM均无活动。在这些妊娠期间未观察到IM病情复发。1例患者在产后第10天被诊断出DM。3例需要中断妊娠治疗。4例妊娠顺利完成,产下健康新生儿。在另一名同时患有与DM相关的抗磷脂综合征(APS)的患者的两次妊娠中观察到胎儿并发症。一次是宫内胎儿死亡,另一次是早产新生儿出生后第3天死亡。

结论

IM患者妊娠罕见。其对疾病活动的影响在妊娠期间和产后都是可变的。当疾病缓解时胎儿预后良好。然而,活动性IM患者的胎儿并发症较为严重。

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