Is pregnancy possible with cystic fibrosis ?

Question

I'm 28 years-old and I would libe to become mother but I have cystic fibrosis. I know that each case is unique but I would like to know the general recommandations to start a pregnancy with cystic fibrosis : cut-off value of respiratory function and...
What are the precautions to take for pregnancy?
And what are the recommandations after birth.
We have already performed genetic counselling for my husband and he is not carrying mutation.
thank you.

Answer

Dear questionner
First, pregnancy should be discussed and planned with your doctor, to be pregnant in good conditions for you and for the baby. Several conditions are required :
First, you must have sufficient respiratory test and have at least 40% or 50% lung function (FEV1 superior 40% or 50%). This value seems to be the cut-off value to allow pregnancy in literature.
You should also have good nutritional status and be at your target weight. Nutritional needs increase from 50 or 100 Kcal supplementary per day at the beginning to 300 Kcal at the end of the pregnancy. So, nutrition demands will increase during pregnancy. You will probably be advised to take supplements such as nutrition shakes to be sure that you’re getting enough calories.
When there is a diabetes mellitus, blood glucose level must be perfectly equilibrated before conception. Pregnancy increases the risk to develop glucose intolerance and gestational diabetes especially in woman with cystic fibrosis. So glucose blood level supervision is reinforced during pregnancy.
Your doctor will check if you take any treatment toxic for the baby or teratogenic medicine. So you must see with your doctor all the medicine you take in order to stop toxic drug if it is possible without problem for you. But you must continue all other medicine to take care of you and have a good health during pregnancy for your baby.
Carrier-screening of the male partner must be performed in order to predict the risk of CF for the child. It has already been performed in your case.

It seems important to realize physical therapy with physical therapist after the birth especially if you have a caesarean section because abdominal pain may complicate bronchial drainage.

After you come back home, you will probably be advised to ask for help. Family should give you a hand to take care of the baby and for domestic work. You’ll be tired and you should continue your treatment and do not stop aerosol or bronchial drainage. (It will be more pleasant to take care of baby than to do a bronchial drainage or an aerosol !). A night help will be fine.

Good luck.
Sincerely yours.

Dr Isabelle Danner-Boucher

11.01.2011