Severe alpha(1)-antitrypsin deficiency and pregnancy

This case study describes a successful pregnancy in a 27-yr-old patient wit h severe emphysema, secondary to alpha(1)-antitrypsin deficiency, genotype PiZZ. Despite significant respiratory compromise, more severe than previous ly reported, no complications ensued, Maternal pulmonary function did not d eteriorate significantly until the 32nd week of pregnancy, with an elective Caesarean section being performed during the 37th,week. This experience suggests that even severe maternal airflow obstruction Is, in itself, not an absolute contra-indication to pregnancy Pre-pregnancy mul tidisciplinary counselling is likely to be helpful in these patients, inclu ding frank discussion on the risks of pregnancy, the prospects of successfu l completion and the mother's future prognosis in relation to caring for th e child.