Chapelon Abric C, Ginsburg C, Biousse V, Wechsler B, de Gennes C, Darbois Y, Janse Marec J, Godeau P, Piette J C
Service de médecine interne, Hôpital de la Pitié-Salpêtrière, Paris, France.
Rev Med Interne. 1998 May;19(5):305-12. doi: 10.1016/s0248-8663(98)80099-4.
To analyze the evolutive profile of sarcoidosis together with reciprocal interactions between pregnancy and sarcoidosis.
All events that occurred during pregnancy in 11 women presenting with sarcoidosis were analyzed. Histological confirmation was obtained for the 11 cases. For all pregnancies were analyzed the course of both sarcoidosis and pregnancy, and the influence of pregnancy on the disease evolution.
Among 33 pregnancies, 23 led to the birth of healthy fetuses (five spontaneous abortions, four voluntary abortions, and one therapeutic abortion). The major event was fetal hypotrophy in six cases. Three of them occurred during pregnancy in prednisone-treated patients with active sarcoidosis. No relapse of cured sarcoidosis or further evolution of sarcoidosis that was inactivated as of the beginning of pregnancy were observed. The course of active sarcoidosis varied, as improvement (one case), worsening (two cases) and stabilization (two cases) were observed. During the first year of follow-up after delivery, four relapses and, in two cases, preliminary signs of the disease were observed.
Apart from the hypothetical but not definite risk of hypotrophy, no negative interaction between sarcoidosis and pregnancy could be established. Pregnancy does not seem to interfere with the course of sarcoidosis. Considering the risk of relapse after delivery, pregnant women presenting with sarcoidosis should benefit from clinical and radiological follow-up.
分析结节病的演变情况以及妊娠与结节病之间的相互作用。
对11例患有结节病的女性在妊娠期间发生的所有事件进行分析。11例均获得组织学确诊。对所有妊娠情况分析了结节病和妊娠的病程，以及妊娠对疾病演变的影响。
在33次妊娠中，23次分娩出健康胎儿（5次自然流产、4次人工流产和1次治疗性流产）。主要事件是6例胎儿发育迟缓。其中3例发生在妊娠期间接受泼尼松治疗的活动性结节病患者中。未观察到已治愈的结节病复发或自妊娠开始就已静止的结节病进一步演变。活动性结节病的病程各异，观察到病情改善（1例）、恶化（2例）和稳定（2例）。在产后随访的第一年，观察到4例复发，2例出现疾病的初步迹象。
除了存在发育迟缓这一假设但不确定的风险外，未发现结节病与妊娠之间存在负面相互作用。妊娠似乎不会干扰结节病的病程。鉴于产后复发的风险，患有结节病的孕妇应接受临床和影像学随访。
