Women with the rare condition fibromuscular dysplasia (FMD) can have safe and successful pregnancies with appropriate monitoring and management, new research shows.
The under-diagnosed condition causes narrowing or enlargement of arteries and can result in high blood pressure, strokes, heart attacks and kidney impairment in young–to-middle aged people, predominantly affecting women of childbearing age.
Professor Tina Chrysochou (pictured) heads the national FMD clinic at Salford Royal, the first of its kind in the country.
She on behalf of colleagues from the Donal O’Donoghue Renal Research Centre at NCA, presented observational data on pregnancy outcomes from patients who have been seen in the clinic over more than five years.
In 185 pregnancies in 83 women, 96 per cent of cases of FMD in childbearing women were only detected post pregnancy. However, they say diagnosing FMD before pregnancy would enable pre pregnancy counselling, an individualized birth plan, renal artery angioplasty as needed and coordinated multidisciplinary care.
The paper in Kidney International Reports also highlights three case studies and the specialist care the women received.
In addition, Prof Chrysochou is the senior author of 10 tips providing practical guidance for clinicians to improve recognition, diagnosis, and management of FMD in everyday practice, published in Clinical Kidney Journal.
Key recommendations emphasize maintaining a high index of suspicion in patients with early-onset or resistant hypertension, pre-eclampsia, pulsatile tinnitus, or unexplained headaches.
High-quality imaging is central to diagnosis, alongside a one-time head-to-pelvis vascular assessment to detect multivessel involvement.
The review also highlights the importance of recognizing atypical presentations.
Management strategies focus on individualized care, while emphasising the importance of strict blood pressure control, smoking cessation, and selective use of antiplatelet therapy.
In addition, the internationally based authors recommend patient education and participation in registries and support networks.
In line with this, the Fibromuscular Dysplasia Society of UK and Ireland is holding its third patient information day in Manchester on 2 October. It will provide information on living well with FMD, an update on the latest thinking, research and international expert consensus and how to get support. It’s free to attend but you must register in advance.