Collagen vascular disease is an umbrella term for any one of the hundreds of autoimmune diseases that affect the soft or connective tissues of the body. Some of the better known collagen vascular diseases include ankylosing spondylitis, lupus, psoriasis, rheumatoid arthritis, scleroderma, psoriatic arthritis, and more. Pregnancies can be complicated by collagen vascular diseases, though some of the various types of the disease are known to cause more serious complications than others.
Rheumatoid arthritis patients, for example, usually experience remission during pregnancy and their pregnancies are typically normal and uneventful. Pregnant women with lupus, on the other hand, are susceptible to a host of dangerous complications during pregnancy. Other types of collagen vascular disease produce a range of potential complications somewhere between rheumatoid arthritis and lupus.
When complications due to collagen vascular disease occur during pregnancy, they can be a threat to the mother, the baby, or both. Maximizing positive outcomes for the mother and baby is the main goal of obstetricians and other specialists involved in managing these pregnancies. The biggest risks to fetuses in the womb are stunted growth, miscarriage, and premature birth. The biggest risks to mothers with high-risk collagen vascular diseases are gestational diabetes and preeclampsia. More rare complications for the mother include decreased lung capacity and blood clots.
Getting control of the disease activity and remaining symptom-free for six months before conception is often recommended. When this is not possible, management of symptoms is usually accomplished through the use of prednisone during the pregnancy. If prednisone is given throughout the pregnancy, then additional large doses must be given during delivery to compensate for adrenal insufficiency that might have developed due to long-term prednisone use.
The growth and development of the baby must be carefully monitored throughout the pregnancy to avoid fetal complications. Viability is the main concern during the first trimester. When the baby makes it to the second trimester, it is considered viable, and monitoring should take place every two to four weeks. This ensures good fetal health throughout the pregnancy. It also gives doctors a chance to notice and treat any potential complications in both the fetus and the mother with collagen vascular disease before they become problems that could be life-threatening to either one.