Rheumatic diseases in pregnant women
Journal Title: Postępy Nauk Medycznych - Year 2010, Vol 23, Issue 5
Abstract
Rheumatic diseases often occur in young people, including women in the reproductive age. The problem of pregnancy is not so rare in this group. The main rheumatic diseases which can we find in pregnant women are: rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). The safety of pharmacotherapy in these diseases during pregnancy and lactation is very important.The most commonly used nonsteoridal anti inflammatory drugs should be used in the lowest therapeutically sufficient dose. Among the glicocorticoids, prednisone and prednisolon have the safest profile in pregnancy. Methotrexate, Cyclophosphamide and Leflunomide are contraindicated in pregnancy. The reports on the safety of the biological treatment during pregnancy are optimistic, however still not sufficient.Pregnancy in women with SLE can be complicated by preeclampsia, premature labour or miscarriage more often than in the healthy population, and it is considered a high- risk pregnancy. Symptoms of preeclampsia and SLE exacerbation are similar, so they need to be correctly differentiate.APS is associated with several pregnancy complications too. Treatment in this disease is still equivocal. Therapeutic schemes involve aspirin and heparins - preferable low molecular weight heparins. Steroids and immunoglobulins are not routinely used. Treatment in APS administrated in early pregnancy increases chances for life delivery to 80%.
Authors and Affiliations
Agnieszka Jasik, Ewa Marcinowska - Suchowierska
Keywords
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