ZAŠTO KOLAGENOZE REMETE TRUDNOĆU?

Snježana Škrablin

It is well known that certain autoimmune disorders are associated with pregnancy loss. Increased perinatal and maternal mortality as well as increased incidence of disease deterioration during pregnancy are correlated to preconceptual disease regulation, incidence of superimposed gestosis and renal failure and, recently, with some sorts of antiphospholipid antibodies. Indeed, investigators have attempted to establish an association between recurrent pregnancy loss and the presence of specific antibodies, irrespective of the presence of other clinical signs or complications of collagenosis. The most serious appears to be the presence of anticardiolipin antibodies and lupus anticoagulant while the significance of other autoantibodies that can be found appears to be much less defined. In the present paper pregnancy complicated by various collagenoses and therapeutic modalities are discussed.

Povezanost autoimunih bolesti i neuspjeha trudnoća poznata je godinama. Povišena perinatalna smrtnost i smrtnost kao i pogoršanje bolesti kod majki u korelaciji je s regulacijom bolesti prije trudnoće, poremetnjama tijekom trudnoće, posebice s nakalemljenom gestozom i bubrežnom insufi cijencijom i postojanjem ili odsutnošću antifosfolipidnih protutijela. Postojanje antifosfolipidnih protutijela danas se sve češće povezuje s habitualnim gubitkom trudnoća, neovisno o postojanju ili odsutnosti drugih komplikacija kolagenoze. Najpogubnije je postojanje antikardiolipinskih protutijela i lupus antikoagulanta, dok je značenje ostalih autoprotutijela koja se mogu susresti u bolesnica s kolagenozama ili antifosfolipidnim sindromom danas smatra manje istraženo. U radu se raspravlja o tijeku trudnoće poremećene kolagenozom i mogućnostima liječenja.