A Successful Monitoring of a Pregnant Woman Suffering from Mixed Connective Tissue Disease-Associated Interstitial Lung Disease: A Case Report.

OBJECTIVE

Current evidence on managing mixed connective tissue disease-associated interstitial lung disease (MCTD-ILD) during pregnancy remains scarce, and no established guidelines address this unique clinical scenario. By reporting this case, in which maternal-fetal health was optimized through multidisciplinary collaboration, dynamic monitoring, and individualized delivery planning, we aim to propose a practical and effective clinical management strategy for healthcare providers.

CASE PRESENTATION: A 36-year-old primipara with an 8-year history of MCTD-ILD had long-term treatment with immunosuppressive agents such as tacrolimus, mycophenolate mofetil and hydroxychloroquine, as well as prednisone before pregnancy. Her condition was stable prior to pregnancy, and she received strict multidisciplinary team (MDT) monitoring during pregnancy. Serial assessments revealed moderate restrictive ventilatory dysfunction on pulmonary function tests and stable interstitial changes on chest CT scans, before delivery, the ILD functional categorization was comprehensively assessed as moderate based on the patient's clinical manifestations, exercise tolerance, and pulmonary function test results. Due to concerns that labor-induced stress could trigger cardiopulmonary decompensation, an elective cesarean section was performed at 39 weeks under neuraxial anesthesia, yielding a healthy male infant (Apgar score 10). Postoperative management included hydroxychloroquine, methylprednisolone initiation and continuous oxygen saturation monitoring (consistently >95%), with no maternal complications observed. The prognosis for both mother and fetus is favorable.

CONCLUSION

Stable CTD-ILD patients can achieve successful pregnancy outcomes through preconception optimization, pregnancy-compatible immunosuppression, and MDT-guided delivery planning. Vigilant monitoring of pulmonary function, imaging, and oxygen saturation is critical, with cesarean section recommended for high-risk cases to mitigate peripartum complications. This case reinforces the need for structured risk stratification and multidisciplinary protocols to safeguard maternal and fetal well-being.