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协调孕产:结缔组织病患者妊娠结局的应对策略

Harmonizing Motherhood: Navigating Pregnancy Outcomes in Connective Tissue Disorders.

作者信息

Mathesan Manju, Ethirajan Shanthi

机构信息

Obstetrics and Gynaecology, Saveetha Institute of Medical and Technical Sciences (Deemed to be University), Chennai, IND.

出版信息

Cureus. 2024 Jun 11;16(6):e62134. doi: 10.7759/cureus.62134. eCollection 2024 Jun.

Abstract

Background Connective tissue disorders encompass a diverse array of autoimmune and hereditary conditions, including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and antiphospholipid antibody syndrome. These disorders present unique challenges during pregnancy due to their complex pathophysiology and potential complications. Understanding their impact on pregnancy outcomes is vital for optimizing maternal and fetal health. Objective To investigate the burden, complications, maternal and fetal outcomes, and prognosis of connective tissue disorders in pregnancy. Methods The study was conducted over one year and six months at Saveetha Medical College and Hospital, Chennai, India, involving 45 pregnant women diagnosed with connective tissue disorders. Standard antenatal investigations were conducted, and participants were monitored throughout the antenatal period. Maternal and fetal outcomes were meticulously evaluated. Results Baseline characteristics revealed a heterogeneous distribution of age and parity among participants, reflecting the diverse nature of connective tissue disorders in pregnancy. Maternal medical outcomes, such as gestational hypertension (GHTN) and gestational diabetes mellitus (GDM), were prevalent, highlighting the necessity of close monitoring. Obstetric outcomes included spontaneous abortion and preterm delivery, indicating elevated risks in this population. Fetal outcomes, including fetal growth restriction and admission to the neonatal intensive care unit, underscored the impact of these disorders on fetal health. Conclusion This study examines pregnant connective tissue disorder burden, complications, maternal and fetal outcomes, and prognosis. The complicated relationship between these illnesses, and pregnancy requires specialist care and close monitoring. The participants' baseline features represent connective tissue condition heterogeneity, affecting clinical practice. Among the study subjects, 40% had RA and 20% had SLE, the most common connective tissue illness. Adverse maternal medical outcomes, like GHTN (27.27% of antiphospholipid syndrome (APS) patients and 22.22% of SLE patients) and GDM (18.18% of APS patients and 11.11% of SLE patients), highlight the need for close maternal health monitoring and management during pregnancy. Overall, this study sheds light on connective tissue abnormalities and pregnancy outcomes. Healthcare providers can improve reproductive health and well-being for various illnesses by knowing these relationships.

摘要

背景 结缔组织疾病涵盖了一系列自身免疫性和遗传性疾病,包括系统性红斑狼疮(SLE)、类风湿关节炎(RA)和抗磷脂抗体综合征。由于其复杂的病理生理学和潜在并发症,这些疾病在孕期带来了独特的挑战。了解它们对妊娠结局的影响对于优化母婴健康至关重要。目的 研究孕期结缔组织疾病的负担、并发症、母婴结局及预后。方法 该研究在印度钦奈的萨维塔医学院和医院进行了一年零六个月,纳入了45名被诊断为结缔组织疾病的孕妇。进行了标准的产前检查,并在整个孕期对参与者进行监测。对母婴结局进行了细致评估。结果 基线特征显示参与者年龄和产次分布不均,反映了孕期结缔组织疾病的多样性。孕产妇医学结局,如妊娠期高血压(GHTN)和妊娠期糖尿病(GDM)较为普遍,凸显了密切监测的必要性。产科结局包括自然流产和早产,表明该人群风险升高。胎儿结局,包括胎儿生长受限和入住新生儿重症监护病房,强调了这些疾病对胎儿健康的影响。结论 本研究考察了孕期结缔组织疾病的负担、并发症、母婴结局及预后。这些疾病与妊娠之间的复杂关系需要专科护理和密切监测。参与者的基线特征体现了结缔组织疾病的异质性,影响临床实践。在研究对象中,40%患有RA,20%患有SLE,这是最常见的结缔组织疾病。不良孕产妇医学结局,如GHTN(抗磷脂综合征(APS)患者中的27.27%和SLE患者中的22.22%)和GDM(APS患者中的18.18%和SLE患者中的11.11%),凸显了孕期密切监测和管理孕产妇健康的必要性。总体而言,本研究揭示了结缔组织异常与妊娠结局的关系。医疗保健提供者通过了解这些关系,可以改善各种疾病患者的生殖健康和福祉。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d120/11238749/e27e91948eb5/cureus-0016-00000062134-i01.jpg

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