PubMed · 13324939
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J H HEJTMANCIK, M A MAGID. Bilateral periureteritis plastica.. https://pubmed.ncbi.nlm.nih.gov/13324939/
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A NATURAL PHENOMENON: Pregnancy is a period of hormone, immunological, metabolic and vascular changes. Modifications of the skin, mucosa and integuments are therefore physiological. The modifications are in pigmentation, but also affect nevi, the connective tissue, vessels and appendices. Modifications in pigmentation exist in more than 9 pregnancies out of 10 in the form of local melanosis. Melasma, also know as the 'pregnancy mask' or chloasma, is fairly rare. These disorders in pigmentation are also observed in black-skinned women. Changes in nevi (darker brown colour, increase in size) occur in around 15% of pregnancies. MODIFICATIONS IN CONNECTIVE TISSUE: Characterised by vergetures, affecting 60 to 90% of women, appear between the 6th and 8th month of pregnancy and for which there is no satisfactory treatment. Vascular modifications are generally proliferative and due to estrogen impregnation that affects the arteriolar and venous systems. Stellar angiomas are present in 50 to 70% of Caucasian women. Bilateral palmar erythema may also be associated with these angiomas. Varicose veins and varicosities of the lower limbs induced by excessive venous pressure are frequent, as well as oedema (salt-water retention, increased capillary permeability). MODIFICATIONS IN THE APPENDICES: These concern the activity of the sweat glands, the size of the sebaceous glands (Montgomery tubercles), the nails and hair growth.
Systemic lupus erythematosus Pregnancy can trigger-off or worsen the disease (60% of lupus flares). The renal damage and hypertension are important prognostic factors. Regarding the foetus, there is a 60% risk of prematurity. The risk of neonatal lupus is basically related to the presence of anti-Ro-SSA and anti-La-SSB antibodies and cannot not be foreseen. Multi-disciplinary surveillance is a necessity for any woman suffering from lupus and wishing to become pregnant. Other connective disorders Pregnancy is rare during scleroderma and has no influence on its progression except in the case of renal damage. Regarding dermatopolymyositis, pregnancy, which is rare, might trigger-off or worsen the disease. Bullous diseases Porphyria may be triggered-off or worsened during pregnancy. The various forms of pemphigus may appear or be enhanced by pregnancy. Various affections The influence of sarcoidosis on pregnancy is negligible. Complications are possible in patients exhibiting a type I or IV Ehlers-Danlos syndrome. Pregnancy can enhance the vascular complications of a pseudoxanthoma elasticum. An exacerbation is possible in the case of a type I neurofibromatosis. Progression varies in the case of psoriasis, atypical dermatitis, acne and Behçet's disease. Genital infections are frequent during pregnancy and often represent a risk for the infant (vaginal candidosis, viral condyloma, gonococci, herpes infection). Varicella The risk of severe neonatal varicella is high when the disease appears in the mother just before or after delivery.
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