Pregnancy and progressive systemic sclerosis

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A case of progressive systemic sclerosis and successful pregnancy is reported. The 82 other reported cases are reviewed with emphasis on the potentially lethal sequela seen 15% of the time (primarily, accelerated renal hypertension, sometimes heralded by proteinuria with renal failure). Accelerated renal hypertension is noted to be present only in primigravid or multigravid patients who manifested sclerodermatous changes prior to the pregnancy. Close blood pressure monitoring and weekly urine tests for protein are recommended as a way to possibly warn the clinician of the onset of this condition. The use of captopril is considered as a possible treatment as there is one reported case of maternal salvage with its use.