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Systemische Sklerose und Schwangerschaft

Eine aktuelle Literaturübersicht

Systemic sclerosis and pregnancy

A review of the current literature

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Zusammenfassung

Die systemische Sklerose ist eine chronische Autoimmunerkrankung, bei der Frauen neunmal häufiger betroffen sind als Männer. Typisch ist heutzutage der späte Kinderwunsch und dementsprechend möchten zunehmend mehr Patientinnen mit dem Krankheitsbild der systemischen Sklerose Kinder bekommen. In diesem Artikel werden die klinischen und immunologischen Aspekte von Schwangerschaft und systemischer Sklerose erläutert. Nach heutiger Auffassung ist eine Schwangerschaft bei den betroffenen Patientinnen prinzipiell möglich unter Berücksichtigung der Krankheitsaktivität, engmaschigem Monitoring, Anpassung der medikamentösen Therapie und enger interdisziplinärer Zusammenarbeit von Gynäkologen und Rheumatologen. Die Krankheitsaktivität vor geplanter Schwangerschaft sollte etwa 3 bis 6 Monate möglichst niedrig sein. Wenn eine schwere Organbeteiligung, frühe dcSSc oder schwere pulmonale arterielle Hypertonie vorliegt, erhöht sich das mütterliche und fetale Risiko um ein Vielfaches.

Abstract

Pregnancy in women diagnosed with systemic sclerosis generally has a favorable outcome according to most recent studies. Women with systemic sclerosis who wish to become pregnant should achieve low disease activity for at least 6 months prior to conception. Regular follow-up of pregnant scleroderma patients by an interdisciplinary medical team including gynaecologists and rheumatologists is necessary to control disease activity and avoid possible complications. Severe organ involvement, early diffuse systemic sclerosis with rapid onset, and pulmonary hypertension ought to discourage patients from pregnancy, as these situations are at high risk of complications for both mother and fetus during pregnancy.

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Danksagung

Für ihre fachliche und sprachliche Unterstützung bedanke ich mich herzlich bei Herrn Kollege Dr. med. Nicksch und Frau Kollegin Dr. med. Schönherr, Rheumatologische Abteilung St. Marien Krankenhaus. Mein zusätzlicher Dank geht an Frau Christiane Fork als Lektorin.

Einhaltung ethischer Richtlinien

Interessenkonflikt. Á. Németh, S. Szamosi, A. Horváth, J. Schönherr, E. Nicksch, Z. Szekanecz und G. Szűcs geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag enthält keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Department of Rheumatology, University of Debrecen Medical and Health Sciences Center, Debrecen, Hungary

    Á. Németh, S. Szamosi, Á. Horváth, Z. Szekanecz & G. Szűcs

  2. Rheumatologische Abteilung, St. Marien-Krankenhaus Ahaus-Vreden Gmbh, Klinikverbund Westmünsterland, An’t Lindeken 100, 48691, Vreden, Deutschland

    Á. Németh, J. Schönherr & E. Nicksch

Authors
  1. Á. Németh
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  2. S. Szamosi
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  3. Á. Horváth
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  4. J. Schönherr
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  5. E. Nicksch
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  6. Z. Szekanecz
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  7. G. Szűcs
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Correspondence to Á. Németh.

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Németh, Á., Szamosi, S., Horváth, Á. et al. Systemische Sklerose und Schwangerschaft. Z. Rheumatol. 73, 175–179 (2014). https://doi.org/10.1007/s00393-013-1267-x

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  • DOI: https://doi.org/10.1007/s00393-013-1267-x

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