Early diagnosis and a good rate of adherence to treatment make patients with cystic fibrosis have an increased expectation, which can make women with this disease want to have children. However, it is necessary to know the possible risks and complications of pregnancy in women with cystic fibrosis.
It is important to have pregnancy planning, in order to adapt the treatment in the best way, in addition to knowing the possible complications and the risk of the child also having the disease. Cystic fibrosis is a genetic and hereditary disease characterized by increased secretion production, which results in respiratory and digestive problems according to the degree of the disease.
As this disease is genetic, if the mother has cystic fibrosis and the father has the gene, the chance of the child having the disease is 50%, so it is important that the team related to the woman's treatment and the obstetrician will guide you regarding the planning and maintenance of pregnancy.
Care during pregnancy
After genetic counseling and evaluation of the possible risks of pregnancy in cystic fibrosis, it is important that the woman receives extra care. Thus, it is important that you go to the doctor more often, at least once a month, in the first 6 months of pregnancy and in the last trimester of pregnancy, it is recommended that the consultation be held every 15 days until the day of delivery.
The pregnant woman with cystic fibrosis must be accompanied by a multiprofessional team made up of the obstetrician, physiotherapist, nutritionist, general practitioner and nursing team, and a series of tests must be performed at each consultation, such as:
- Complete physical examination; Assessment of pulmonary function; Assessment of general nutritional status, with the calculation of BMI; Measurement of oxygen saturation; Sputum culture to check for the presence of microorganisms in the respiratory tract.
It is recommended that pregnant women with cystic fibrosis have a total weight gain of 11 kg and it is usually indicated by the nutritionist to use food supplements as well as to feed through a tube so that not only the woman but also the child have adequate nutrition, since in cystic fibrosis food digestion is compromised due to loss of pancreatic function.
In addition, it is important that physicians evaluate the possibility of adaptation in treatment, especially with regard to the use of antimicrobials, as some are contraindicated in pregnancy due to their possible effects on the fetus. On the other hand, the use of pancreatic enzymes must be maintained during pregnancy and during the breastfeeding phase, without any contraindication for the mother or the baby.
Possible risks and complications
The risks and complications of pregnancy in cystic fibrosis are many, but they depend on the general condition of the woman as well as on her degree of adherence to treatment and evolution of the disease, such as:
- Pulmonary impairment: may result in fetal growth retardation and prematurity; Compromised nutritional status: it can decrease the conception rate, low birth weight and gestational diabetes; Gestational diabetes: increased risk of fetal abnormalities, especially if blood glucose levels are too high in the first trimester of pregnancy; Respiratory instability: may result in death of the mother or increase the chance of miscarriage and prematurity.
In addition, if the woman has undergone a lung transplant, it is recommended that she wait about 2 years after the transplant before she becomes pregnant, if that is the wish. This is because lung transplantation makes pregnancy risky, since the presence of the fetus can increase the chances of organ rejection, in addition to the fact that some drugs used after transplantation, which are immunosuppressive drugs, can cross the placenta and result changing baby's development. Pregnancy after transplantation may also increase a woman's chances of developing gestational diabetes and prematurity with restricted intrauterine growth.
It is important that after delivery the baby undergo diagnostic tests to assess whether he has the disease, whether he has the cystic fibrosis gene or is healthy, so that treatment can be established if necessary.
