Successful term pregnancy in a patient with Wegener's granulomatosis: case report and literature review

Objective: To present a case of successful term pregnancy in a patient with known Wegener's granulomatosis (WG). Design: Case report. Setting: University Hospital, Department of Obstetrics and Gynecology. Patient(s): A 22-year-old primigravida pregnant woman with a history of WG diagnosed 5 years before. Intervention(s): The patient was treated with corticosteroids and azathioprine throughout pregnancy, and cyclophosphamide was added postpartum. Main Outcome Measure(s): The disease was in partial remission at the onset of pregnancy, but two relapses occurred, at 33 weeks' gestation and 15 days after delivery. A 3150-g healthy boy was delivered at 37 weeks' gestation. Conclusion(s): Pregnancy in patients with WG requires preconceptional planning, careful clinical management, and vigorous treatment of active disease. There are 36 cases of WG in pregnancy reported in the literature. Owing to this rarity, the management is individualized and the pregnancy outcome is variable. Antenatal management and therapeutic options are discussed and a short review of the literature is presented. (Fertil Steril (R) 2008;89:457.e1-5. (C) 2008 by American Society for Reproductive Medicine.)