Pericarditis Management in Individuals Contemplating Pregnancy, Currently Pregnant, or Breastfeeding.
Pericarditis Management in Individuals Contemplating Pregnancy, Currently Pregnant, or Breastfeeding.
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考虑怀孕、目前怀孕或母乳喂养的个体的心包炎管理。
DOI：
10.1007/s11886-023-01930-6
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发表时间：
2023
影响因子：
3.7
通讯作者：
Weber,Brittany
中科院分区：
文献类型：
--
作者：
Pryor,Katherine;Tarter,Laura;Economy,Katherine;Honigberg,MichaelC;Valente,AnneMarie;Garshick,Michael;Weber,Brittany
综述目的心包炎使妊娠计划、妊娠或产后复杂化，处理方法需要特殊考虑。在这里，我们旨在总结最新的研究、诊断和治疗策略。最近的发现妊娠期间发生的生理性心血管(CV)适应使诊断变得复杂，但对于大多数患者来说，在适当的临床背景下，心电图(CG)和经胸超声心动图(TTE)足以诊断心包炎。阿司匹林和非类固醇抗炎药(NSAIDs)可以根据需要使用到怀孕20周。鼓励在任何时候使用秋水仙碱，以减少复发的风险。糖皮质激素可以在怀孕和哺乳期间以尽可能低的剂量和最少的时间使用。对于持续性、复发性或难治性心包炎，或当上述治疗方法被禁忌时，可能会考虑在妊娠期间使用IL-1抑制药，认识到怀孕患者的数据有限。最后，我们鼓励使用多学科团队的方法，包括妇产科、心脏病学和风湿病学，如果有的话。总结育龄女性心包炎的诊断和治疗需要特别考虑。虽然有非常有效的治疗选择，但需要更多的数据和更大的国际登记来改进治疗建议。
Purpose of ReviewPericarditis complicates pregnancy planning, pregnancy, or the postpartum period, and the management approach requires special considerations. Here, we aim to summarize the latest research, diagnostic, and treatment strategies.Recent FindingsPhysiologic cardiovascular (CV) adaptations occurring during pregnancy complicate diagnosis, but for most patients, an electrocardiogram (ECG) and transthoracic echocardiogram (TTE) are sufficient to diagnosis pericarditis in the appropriate clinical context. Aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) can be used until 20 weeks gestation as needed. The use of colchicine is encouraged at any time point to reduce the risk of recurrence. Glucocorticoids may be used at the lowest possible dose for the least amount of time throughout pregnancy and breastfeeding. For incessant, recurrent, or refractory pericarditis, or when the above therapies are contraindicated, there may be a consideration of the use of IL-1 inhibition during pregnancy, recognizing the limited data in pregnant patients. Finally, we encourage the use of a multidisciplinary team approach including OB-GYN, cardiology, and rheumatology when available.SummaryThe diagnosis and treatment of pericarditis in female patients of reproductive age require special considerations. Although highly effective treatment options are available, there is a need for greater data and larger international registries to improve treatment recommendations.