Cystic fibrosis (CF) and Pregnancy

Advice to a cystic fibrosis sufferer regarding pregnancy

For a cystic fibrosis sufferer, there is no standard advice. In short, before she embarks upon a pregnancy, she must ensure she is in a satisfactory physical shape without any serious complications of cystic fibrosis.

The one important contraindication to pregnancy for a cystic fibrosis sufferer is if she has developed pulmonary hypertension. This is a condition where the blood pressure in the arteries in the lungs is abnormally high. Pregnancy in such a situation could cause heart failure, which many necessitate terminating the pregnancy as a life-saving measure.

The physician looking after the woman will carefully assess the effect of the disease, including on her lungs, the gut, pancreas (risk of diabetes) and heart, before giving a considered and informed advice.

Prospects for the offspring of a cystic fibrosis (CF) sufferer

This is a difficult area. One consideration is the inevitably limited life-span of the mother. This needs to be looked at critically by the prospective parents.

The second issue is the possibility of the child being affected. The mother will definitely pass on the rogue gene. It may be important to check whether the partner carries the gene. About 5% of the white population carries the gene, so the chance among this population group is relatively high. The rate among those of African or Oriental ancestry is much lower.

A test to check the status of her partner is available but it detects only about 70% of the carriers, and therefore there is still a risk of a carrier being missed.

Effect of pregnancy on cystic fibrosis (CF)

It is possible for pregnancy to worsen cystic fibrosis symptoms. It is therefore imperative that a careful eye is kept on the pregnant woman through the course of the pregnancy. Pregnancy with cystic fibrosis is regarded and always managed as high risk.

Physiotherapy and antibiotics during pregnancy in Cystic Fibrosis

Physiotherapy and antibiotics are the mainstay of cystic fibrosis management. These will continue to be needed during pregnancy. Penicillin or a form of cephalosporin commonly used to prevent infection are safe.

Also inhalational drugs to help dilate the lungs (bronchodilators) will almost certainly be required on a regular basis. All these are known to be safe.

Risk to the baby in CF

By virtue of the respiratory and nutritional problems cystic fibrosis patients encounter, the risk of fetal growth restriction in the womb is quite considerable. Sometimes it gets so bad that preterm delivery becomes inevitable.

Other maternal complications such as respiratory or heart failure may also prompt preterm delivery.

Induction of labor in cystic fibrosis

If labor is to be induced, it will be done the same as for everybody else. Prostaglandin E - which is the most popular induction agent - is safe to use in cystic fibrosis sufferers. Oxytocin (Syntocinon) is also used, when necessary, to augment labor.