Familial Mediterranean Fever in Pregnancy.

IF 4.3 4区 医学 Q1 OBSTETRICS & GYNECOLOGY Obstetrical & Gynecological Survey Pub Date : 2024-10-01 DOI:10.1097/OGX.0000000000001316
Alana Davidson, Jeffrey A Kuller, Sarah K Dotters-Katz, Rachel L Wood
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Abstract

Importance: Though the incidence of familial Mediterranean fever (FMF) in pregnancy is rare, understanding the etiology and symptomatology of FMF is essential for obstetric treatment of patients with FMF.

Objective: Familial Mediterranean fever is a hereditary periodic fever syndrome that has unique obstetric considerations. Familial Mediterranean fever is typically characterized by recurrent episodes of high-grade fevers, pleuritis/pericarditis, and arthritis lasting 1-3 days with complete recovery seen in between episodes. Familial Mediterranean fever is seen worldwide, but particularly in patients of Mediterranean descent. Its incidence varies across ethnicities.

Evidence acquisition: This article provides a comprehensive review of existing literature.

Results: It is well established that colchicine is safe and effective to use during pregnancy in patients with FMF to control and prevent flares. Although most pregnancies progress without negative outcomes, FMF has been shown in the literature to be associated with preterm birth and premature rupture of membranes. Its impact on increasing the rate of fetal growth restriction and hypertensive disorders is less understood. Additionally, FMF flares may be suppressed in pregnancy, whereas other sources report that flares are similar to those outside of pregnancy in terms of frequency, type of symptoms, and severity. Breastfeeding is safe in patients with FMF who are taking colchicine. Genetic counseling can be offered to patients with FMF, but in utero diagnostic testing is generally not pursued solely for the indication of FMF diagnosis in the fetus.

Conclusions and relevance: Further investigation of the impact of FMF on pregnancy is needed for advancing our understanding of the condition and optimizing care for pregnant individuals with FMF.

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妊娠期家族性地中海热
重要性:虽然妊娠期家族性地中海热(FMF)的发病率很低,但了解 FMF 的病因和症状对于 FMF 患者的产科治疗至关重要:家族性地中海热是一种遗传性周期性发热综合征,具有独特的产科注意事项。家族性地中海热的典型特征是反复发作的高热、胸膜炎/心包炎和关节炎,持续 1-3 天,发作间歇期完全恢复。家族性地中海热常见于世界各地,尤其是地中海后裔患者。其发病率因种族而异:本文对现有文献进行了全面回顾:结果:秋水仙碱在 FMF 患者妊娠期间用于控制和预防复发是安全有效的,这一点已得到公认。尽管大多数妊娠过程不会出现不良后果,但文献显示 FMF 与早产和胎膜早破有关。目前还不太清楚它对增加胎儿生长受限和高血压疾病发生率的影响。此外,妊娠期 FMF 复发可能会受到抑制,而其他资料显示,FMF 复发在频率、症状类型和严重程度方面与妊娠期外相似。服用秋水仙碱的FMF患者进行母乳喂养是安全的。可为 FMF 患者提供遗传咨询,但一般不会仅仅为了诊断胎儿是否患有 FMF 而进行子宫内诊断检测:需要进一步研究 FMF 对妊娠的影响,以增进我们对该疾病的了解,并优化对妊娠 FMF 患者的护理。
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来源期刊
CiteScore
2.70
自引率
3.20%
发文量
245
审稿时长
>12 weeks
期刊介绍: ​Each monthly issue of Obstetrical & Gynecological Survey presents summaries of the most timely and clinically relevant research being published worldwide. These concise, easy-to-read summaries provide expert insight into how to apply the latest research to patient care. The accompanying editorial commentary puts the studies into perspective and supplies authoritative guidance. The result is a valuable, time-saving resource for busy clinicians.
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