Pregnancy Concerns in Marfan Syndrome and Loeys-Dietz Syndrome
20:18-22:44
So plan ahead. This is preconception counseling so before you get pregnant, it's important to have conversations with your doctors.
ではまず、妊娠前の準備についてお話します。プレコンセプション（妊娠前）カウンセリングのことですが、妊娠前に専門医に相談しておくことは重要になります。
So some of the things that you need to consider are some women are on the angiotensin receptor blockers like Losartan and it's important to get off of those medicines before you would get pregnant because those especially if they're taken early in the pregnancy like before you actually know you're pregnant, you could have a higher risk of birth defects specifically to the kidneys of the baby.
まず、ロサルタンといったARBを服用している方は、妊娠前に中止する必要があります。特に妊娠初期の服用、例えば、妊娠判明前に服用しているような場合には、出生異常が起こるリスクが高まります。特に胎児の腎臓に影響が出ると言われています。
So we want you to be off of that medicine for at least six weeks before you would start to try to get pregnant and we transition people on to beta blockers and the beta blocker we prefer is metoprolol and this can be done with the help of your cardiologist.
そのため、妊娠に取り組む最低6週間前にはARBを中止し、βブロッカーへと切り替えます。私達が好ましいと考えるβブロッカーはメトプロロールですが、循環器専門医の協力を得ながら決定します。
Other things we want imaging studies before you would get pregnant. We want to sort of a, we want to avoid radiation at all possible for the fetus and so we want to look at your aorta, the rest of the cardiovascular system, and the spine and that can be done with a CT scan or an MRI prior to getting pregnant to just have some good information going into the pregnancy.
妊娠前の画像検査も重要です。できる限り胎児の放射線被爆は避けたいのですが、妊娠前にCTやMRIで大動脈や心臓血管系、脊柱などの検査を行い、妊娠に備えて情報を集めます。
Also we talked about with genetic counseling. We know that if you have Marfan or Loeys-Dietz syndrome, there's a 50% chance of passing this on to any offspring each time you get pregnant and so there's ways to test in the pregnancy or decide if you even want to do testing.
遺伝子カウンセリングを受けることもできます。マルファン症候群あるいはロイス・ディーツ症候群では、妊娠の度に子供に遺伝する確率は50%です。妊娠中に検査を受けたり、検査を受けるかどうかを決めることもできます。
In terms of discussing risks, I'm going to talk about that on the next slide in more detail but it is important to sort of just hear about risk with that, with a maternal fetal medicine specialist or a high-risk obstetrician and we can meet with people actually like you guys that have Marfan and Loeys-Dietz before you would get pregnant just sort of talk about everything and then talk about the best way to achieve a pregnancy.
リスクに関しては、次のスライドで詳しくお話しますが、周産期医学専門医あるいはハイリスク出産専門医から話を聞いておくことが重要です。私達も実際にマルファンやロイス・ディーツの患者さんと妊娠前にお会いし、あらゆるお話して最善の妊娠方法についてお伝えしjます。
If you're not actively trying to get pregnant, contraception is important and we think that, you know, there's differences in opinion about this but in general to avoid estrogen-containing contraceptives but we think that progesterone is potentially safe and so you can sort of talk through the options of contraception with your doctors.
積極的に妊娠を望まないのであれば、避妊も重要になります。異論もありますが、一般的にエストロゲンを含む避妊薬は避けた方がいいとされています。プロゲステロンは安全である可能性がありますが、避妊薬については医師に相談してください。
The Marfan Foundation did not participate in the translation of these materials and does not in any way endorse them. If you are interested in this topic, please refer to our website, Marfan.org, for materials approved by our Professional Advisory Board.
The Marfan Foundation は、当翻訳には関与しておらず、翻訳内容に関してはいかなる承認も行っておりません。このトピックに興味をお持ちの方は、Marfan.org にアクセスし、当協会の専門家から成る諮問委員会が承認した内容をご参照ください。
