Panminerva Medica 2021 Mar 09

DOI: 10.23736/S0031-0808.21.04198-7

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Management of acute and recurrent pericarditis in pregnancy

Lisa SERATI ¹ ✉, Carla CARNOVALE ², Silvia MAESTRONI ³, Martino BRENNA ¹, Aurora SMERIGLIA ¹, Agnese MASSAFRA ¹, Emanuele BIZZI ¹, Chiara PICCHI ¹, Enrico TOMBETTI ⁴, Antonio BRUCATO ⁴

¹ Department of Internal Medicine, Fatebenefratelli Hospital, Milan, Italy; ² Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences L. Sacco, Luigi Sacco University Hospital, Università di Milano, Milan, Italy; ³ Department of Internal Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy; ⁴ Department of Biomedical and Clinical Sciences, University of Milan, Fatebenefratelli Hospital, Milan, Italy

This review summarizes the currently available evidence on the management of acute and recurrent pericarditis during pregnancy, focusing on the safety of diagnostic procedures and treatment options for the mother and foetus. Family planning should be addressed in women with recurrent pericarditis of reproductive age and adjustment of therapy should be considered before a planned pregnancy. The treatment of pericarditis in pregnancy is similar to that for non-pregnant women but considers current knowledge on drug safety during pregnancy and lactation. The largest case series on this topic described 21 pregnancies with idiopathic recurrent pericarditis. Pregnancy should be planned in a phase of disease quiescence. Non-steroidal anti-inflammatory drugs can be used at high dosages until the 20th week of gestation (except low-dose aspirin 100 mg/die). Colchicine is allowed until gravindex positivity; after this period, administration of this drug during pregnancy and lactation should be discussed with the mother if its use is important to control recurrent pericarditis. Prednisone is safe if used at low-medium doses (2,5 - 10 mg/die). General outcomes of pregnancy in patients with pericarditis are good when the mothers are followed by a multidisciplinary team with experience in the field.

KEY WORDS: Pericarditis; Pregnancy; Childbearing age; Drug therapy; Breastfeeding