Early diagnosis and good adherence to treatment mean that patients with cystic fibrosis have an increased expectation, which may cause women with cystic fibrosis to have children. However, it is necessary to know the possible risks and complications of gestation in women with cystic fibrosis.
It is important to have gestational planning in order to adapt the treatment in the best way, besides 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 production of secretion, resulting in respiratory and digestive problems according to the degree of disease. Learn about the symptoms of cystic fibrosis.
Since this disease is genetic, if the mother has cystic fibrosis and the father has the gene, the child's chance of having the disease is 50%, so it is important that the team related to the treatment of women and the obstetrician guide with regard to the planning and maintenance of pregnancy.
Care during pregnancy
After genetic counseling and evaluation of the possible risks of gestation in cystic fibrosis, it is important that the woman receives the double care. It is therefore 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 performed every 15 days until the day of delivery.
The pregnant woman with cystic fibrosis must be accompanied by a multiprofessional team consisting of the obstetrician, physiotherapist, nutritionist, general practitioner and nursing team, and a series of examinations should be performed at each visit, such as:
- Complete physical examination;
- Evaluation of pulmonary function;
- Evaluation of the general nutritional status, with the calculation of BMI;
- Measurement of oxygen saturation;
- Sputum culture to verify the presence of microorganisms in the respiratory tract.
It is recommended that the pregnant woman with cystic fibrosis have a total weight gain of 11 kg and it is usually indicated by the nutritionist the use of food supplements as well as feeding through a tube so that not only the woman but also the child have adequate nutrition, since in the cystic fibrosis the digestion of the food is compromised due to the loss of the pancreatic function.
In addition, it is important that physicians evaluate the possibility of treatment adaptation, especially with regard to the use of antimicrobials, since some are contraindicated in pregnancy because of their possible effects on the fetus. On the other hand, the use of pancreatic enzymes should be maintained during gestation and in the lactation phase, without any contraindication for the mother or the baby. Understand how the treatment is done for cystic fibrosis.
Possible risks and complications
The risks and complications of pregnancy in cystic fibrosis are many, but they depend on the general state of the woman as well as her degree of compliance with the treatment and evolution of the disease, such as:
- Pulmonary compromise : may result in fetal growth retardation and prematurity;
- Impaired nutritional status : may decrease conception rate, low birth weight and gestational diabetes;
- Gestational diabetes : increased risk of fetal abnormalities, especially if blood glucose levels are very 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 lung transplantation, it is recommended that she wait about 2 years after the transplant to become pregnant, if that is the wish. This is because lung transplantation makes pregnancy risky, since the presence of the fetus may increase the chances of rejection of the organ, and some medicines used after transplantation, which are the immunosuppressive drugs, can cross the placenta and result in change in the baby's development. Pregnancy after transplantation may further increase a woman's chances of developing gestational diabetes and of prematurity with intrauterine growth restriction.
It is important that after delivery the baby undergoes 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. Here's how to tell if your baby has cystic fibrosis.
