Management of Rheumatologic Diseases in Pregnancy

Oier Ateka-Barrutia; Catherine Nelson-Piercy


Int J Clin Rheumatol. 2012;7(5):541-558. 

In This Article

Future Perspective

Results of ongoing studies looking for biomarkers of disease activity of different rheumatic diseases may be helpful in order to predict flares, tailor the treatment and management to each patient's profile, and to differentiate disease activity from preeclampsia in ambiguous cases. Early serological, urinary and ultrasound markers of preeclampsia and other poor obstetric outcomes are a promising and developing field of research, which may allow a better tailoring of treatment and surveillance during pregnancy.

Well-designed prospective studies based on international consensus are needed in order to confirm the findings from observational studies, to clarify contradictory results between old and new studies, and to incorporate new risk factors not previously described. With regards to less common disorders, publication of larger series may lead to a better understanding of their behavior in pregnancy and the best management approach.

As randomized trials of medications in pregnancy are not generally conducted, greater experience with drugs such as biologics, pulmonary hypertension medications, new anticoagulants and other new treatments may help to inform counseling and decide on the best treatment options. Results of ongoing randomized trials investigating the value of statins for preeclampsia and the role of HCQ for the prevention of CHB may bring interesting new insights into the approach of these disorders.