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Monday, June 30, 2014

Scleroderma and pregnancy

June is National Scleroderma Awareness Month. Scleroderma is a group of diseases that result in the abnormal growth of connective tissue. Connective tissue is tissue that supports your skin and internal organs, like your kidneys, lungs and heart. Scleroderma is a chronic condition meaning that it lasts for a long time and can affect many aspects of your life.
If you have scleroderma, your body makes too much of a connective tissue protein called collagen. When too much collagen builds up in your body, it causes your skin and connective tissues to get hard or thick. Scleroderma can lead to pain and swelling in your muscles and joints. There are two main kinds of scleroderma: localized and systemic. Both can be mild to severe, with periods of remission (wellness) and flares (illness).
Localized scleroderma only affects certain parts of your body, like your skin, skin tissues and sometimes muscles. Localized scleroderma doesn’t harm major organs and often gets better or goes away over time without treatment. But sometimes it can be severe and cause lasting skin changes.
Systemic scleroderma can affect the whole body, including your skin, tissues, blood vessels and major organs, like your heart, lungs and kidneys.
If you have scleroderma and you’re thinking about getting pregnant,  you should schedule a preconception checkup with your health care provider. If you have localized scleroderma, it may not affect your pregnancy at all. But systemic scleroderma can cause problems with your heart, lungs or kidneys. These complications are most likely to appear during the first three years of scleroderma symptoms, and can cause health difficulties for you and your baby during pregnancy. For this reason, it’s best not to get pregnant during the first three years of symptoms.
If you have systemic scleroderma, you may be more likely than other pregnant women to have:
• Preeclampsia and other kinds of high blood pressure,
• Poor growth in your baby,
• Cesarean birth (C-section).
Right now, there is no specific treatment that stops the body from making too much collagen. However, doctors use several types of medication to control the symptoms. But not all of these are safe to use during pregnancy. Some can cause birth defects if a woman takes them while she is pregnant. That is why it is so important to discuss your condition with your doctor before pregnancy.
During pregnancy a woman with scleroderma may be treated by multiple doctors, including a rheumatologist as well as a high-risk obstetrician. Depending on her individual symptoms, a pregnant woman may need to see a few other providers to treat specific complications. Fortunately though, with today’s medical care, many women with scleroderma can have successful pregnancies.

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