Pawan Singh1, Aadhaar Dhooria2, Manish Rathi3, Ritesh Agarwal1, Kusum Sharma4, Varun Dhir2, Ritambhra Nada5, Ranjana Minz6, Vanita Suri7, Sanjay Jain2, Aman Sharma2. 1. Department of Pulmonary Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India. 2. Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India. 3. Department of Nephrology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. 4. Department of Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. 5. Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. 6. Department of Immunopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. 7. Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Abstract
AIM: Antineutrophil cytoplasmic antibody-associated vasculitides (AAV) are a group of small vessel vasculitis with systemic presentations and considerable morbidity and mortality. Pregnancy in these patients poses a significant therapeutic challenge. There is limited published literature regarding pregnancy in AAV. METHODS: Two cases of successful pregnancy outcomes in patients with active AAV are described. A systematic review was conducted on the lines of the PRISMA statement for conducting systemic reviews: PubMed (inception of PubMed until 30 April 2017, English language only) and EmBase databases were searched using the following terms: 'pregnancy' AND 'ANCA associated vasculitis' OR 'granulomatosis with polyangiitis' OR 'eosinophilic granulomatosis with polyangiitis' OR 'microscopic polyangiitis' OR 'Churg-Strauss syndrome' OR 'Wegener's granulomatosis'. RESULTS: One hundred and thirty-seven pregnancies were documented in 110 patients of AAV. Vasculitis diagnosis was made before pregnancy in 69, during pregnancy in 32 and after pregnancy in 9 patients. Mean age at the time of pregnancy was 29.3 ± 5.3 years. There were 91 term pregnancies, 28 were preterm pregnancies, 15 abortions and 3 still births; 78 had normal delivery and 26 had caesarian section. CONCLUSION: Successful pregnancies have been reported in AAV patients.
AIM: Antineutrophil cytoplasmic antibody-associated vasculitides (AAV) are a group of small vessel vasculitis with systemic presentations and considerable morbidity and mortality. Pregnancy in these patients poses a significant therapeutic challenge. There is limited published literature regarding pregnancy in AAV. METHODS: Two cases of successful pregnancy outcomes in patients with active AAV are described. A systematic review was conducted on the lines of the PRISMA statement for conducting systemic reviews: PubMed (inception of PubMed until 30 April 2017, English language only) and EmBase databases were searched using the following terms: 'pregnancy' AND 'ANCA associated vasculitis' OR 'granulomatosis with polyangiitis' OR 'eosinophilic granulomatosis with polyangiitis' OR 'microscopic polyangiitis' OR 'Churg-Strauss syndrome' OR 'Wegener's granulomatosis'. RESULTS: One hundred and thirty-seven pregnancies were documented in 110 patients of AAV. Vasculitis diagnosis was made before pregnancy in 69, during pregnancy in 32 and after pregnancy in 9 patients. Mean age at the time of pregnancy was 29.3 ± 5.3 years. There were 91 term pregnancies, 28 were preterm pregnancies, 15 abortions and 3 still births; 78 had normal delivery and 26 had caesarian section. CONCLUSION: Successful pregnancies have been reported in AAV patients.