Pregnancy and Rheumatic Diseases

M. Gayed; C. Gordon

Disclosures

Rheumatology. 2007;46(11):1634-1640. 

In This Article

Summary

Pregnancies in women with rheumatic diseases require a multi-disciplinary, carefully monitored, coordinated approach before, during and after pregnancy to ensure the best possible success for mother and baby. In contrast to SLE, APS, vasculitis and systemic sclerosis there is little evidence for poor maternal or fetal outcomes in RA or other forms of inflammatory arthritis such as psoriasis and seronegative spondyloarthropathies. Prior to pregnancy it is important to counsel the mother concerning potential complications, establish disease activity control, screen for hypertension and renal involvement, exclude pulmonary hypertension and make appropriate changes to the woman's therapy. During pregnancy it is essential to monitor all aspects of disease activity such as renal involvement, as well as pregnancy complications such as IUGR, thrombo-embolic disease and pre-eclampsia, particularly in patients with SLE, APS, vasculitis and systemic sclerosis. After pregnancy it is essential to counsel the mother on postpartum issues such as breast-feeding and contraception, as well as to monitor for and treat any postpartum flares as these are common in all the rheumatic diseases.

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