弥漫性皮肤系统性硬化症可能发生在育龄妇女中。即使在出现与硬化症相关的症状之前,该人群的怀孕也与不良产科和产妇结局的风险显着增加有关。我们报告了一例30岁的弥漫性皮肤系统性硬化症妇女的妊娠管理和结局。她的怀孕过程很好,并得到了包括产科医生和风湿病学家在内的团体咨询的协助。阴道分娩是患者的首选,因为她的下腹部皮肤有不规则的皮肤紧绷。她接受了引产和脊髓-硬膜外联合镇痛,并成功交付。重要的是,这些怀孕需要计划,在可能的情况下,以便有机会提前为妇女及其伴侣提供咨询,并降低任何风险。这些怀孕应该被认为是高风险的,他们需要密切的产前监测和良好的监督专家多学科团队在高风险怀孕方面经验丰富。皮肤系统性硬化症患者的分娩管理具有挑战性,分娩镇痛阴道分娩是剖宫产的另一种选择。
Diffuse cutaneous systemic sclerosis may occur in women of childbearing age. Pregnancies in this population are associated with a markedly increased risk of adverse obstetric and maternal outcomes even before the onset of symptoms related to sclerosis. We report a case involving the management and outcome of pregnancy in a 30-year-old woman with diffuse cutaneous systemic sclerosis. The course of her pregnancy was good and was assisted by a group consultation including obstetricians and rheumatologists. Vaginal delivery was the patient\'s preferred choice because she had irregular skin tightness in her lower abdominal skin. She underwent induction of labor and combined spinal-epidural analgesia, and successfully delivered. Importantly, these pregnancies need to be planned, where possible, to allow the opportunity to counsel women and their partners in advance and to decrease any risks. These pregnancies should be considered high risk, and they require close antenatal monitoring and good supervision from an expert multidisciplinary team experienced in high-risk pregnancies. The management of delivery for patients with cutaneous systemic sclerosis is challenging, and vaginal delivery with labor analgesia is an alternative option to cesarean section.