Multiple pregnancy in case of idiopathic polymyositis: case report and literature review

The case report contains a description of multiple pregnancy in a patient with idiopathic polymyositis, which involves skin, muscles of upper and lower limbs, heart and provides expressed heart failure progressing during gestation. This report is remarkable for spontaneous multiple pregnancy in a patient of the senior reproductive age suffering from idiopathic polymyositis for several years and receiving the background glucocorticosteroid (GC) therapy and methothrexate. In the early stage of pregnancy and following the withdrawal of methothrexate, a spurt in disease was observed with aggravated clinical signs of heart failure that required increasing the course doses of GCs with further reduction thereof in the second and third trimesters. The conclusion highlights the necessity of pre-conception preparation of this category of women in order to achieve sustained inactivation of polymyositis at the onset of pregnancy. Delivery of such category of women shall take place in the III grade perinatal institution incorporating the units of child intensive care and neonatal pathology to enhance the fetal viability and to ensure efficiency of rehabilitation measures.