Rheumatologic Disorders In Pregnancy

From Anvita Health Wiki

Contents 1 Complications 2 Management 3 More General Terms 4 Additional Terms 5 References

Complications

• increased risk of pre-eclampsia/eclampsia [1]
• anti- rheumatic agents, especially DMARDs may be teratogenic

Management

• preconception counseling in necessary
• fertility of women with rheumatoid arthritis is compartable to normal patients
• 75% of women with rheumatoid arthritis experience spontaneous remission of symptoms, generally beginning in the second trimester
• most women can safely discontinue therapy for rheumatoid arthritis during pregnancy
• low-dose prednisone, hydroxychloroquine & sulfasalazine may be used during pregnancy if necessary
• NSAIDs may be continued during the first & second trimesters but should be discontinued in the third trimester because of the risk of premature closure of the ductus arteriosus in utero
• TNF alpha inhibitors should be discontinued prior to conception (safety data insufficient)
• most pregnant women with rheumatoid arthritis experience a flare after delivery, thus DMARD therapy should be restarted immediately after delivery unless the woman is breastfeeding
• with severe rheumatoid arthritis, breastfeeding should be avoided & DMARD therapy restarted

More General Terms

• pregnancy disorder; obstetric disorder
• rheumatologic disease

Additional Terms

• dementia

References

1. Journal Watch 24(14):115, 2004 Wolfberg AJ, Lee-Parritz A, Peller AJ, Lieberman ES. Association of rheumatologic disease with preeclampsia. Obstet Gynecol. 2004 Jun;103(6):1190-3. PMID: [1]
2. Medical Knowledge Self Assessment Program (MKSAP) 15, American College of Physicians, Philadelphia 2009

rheumatologic disorders in pregnancy