Abstract
Objective
The course of hereditary angioedema (HAE) and the efficacy and safety of human C1-INH
concentrate were appraised during pregnancy and the postpartum period, in patients
with HAE.
Study design
Retrospective analysis of clinical data on 118 pregnancies (82 full-term and 36 abortions)
in 41 female patients, extracted from the National HAE Registry, medical charts and
patient diaries.
Results
HAE attack frequency increases in 48% of pregnancies, whereas 33% of pregnancies were
associated with mitigation of clinical signs and 19% of the pregnancies had no influence
on the course of HAE, as compared to disease severity seen during the 2-year period
preceding the pregnancy. During 46 full-term pregnancies, 26 patients reported attacks;
52% of these occurred in the third trimester. Abdominal attacks are the most common
presentation of HAE during pregnancy. Attack number was significantly higher in patients
who had sustained their initial attack before 8 years of age. Attack number increased
during the third trimester if the fetus was afflicted by HAE. During the postpartum
period, attacks occurred in 6/82 pregnancies. Patients received 91 vials of C1-INH
concentrate altogether for the relief of acute attacks and for short- or long-term
prophylaxis during pregnancy. This therapy was effective in all instances; no adverse
effects were observed.
Conclusions
Pregnancy can either aggravate or mitigate edematous attacks, or alternatively, it
may have no influence on the severity of the disease. According to our experience,
C1-INH concentrate is an effective and safe therapeutic option during pregnancy.
Keywords
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Article info
Publication history
Published online: June 02, 2010
Accepted:
May 15,
2010
Received in revised form:
March 19,
2010
Received:
December 16,
2009
Identification
Copyright
© 2010 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
