scholarly journals AB1218 MATERNAL-FETAL MORBIDITY AND MORTALITY AMONG PREGNANT PATIENTS WITH RHEUMATIC DISEASES IN THE CLINIC OF PREGNANCY AND ARTHRITIS OF THE SALVADORAN SOCIAL SECURITY INSTITUTE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1900.2-1901
Author(s):  
R. I. López ◽  
R. Montufar ◽  
D. Alpizar-Rodriguez
Keyword(s):  
Rheumatoid Arthritis ◽  
Birth Weight ◽  
Rheumatic Diseases ◽  
Gestational Age ◽  
Lupus Erythematosus ◽  
Pregnancy Outcomes ◽  
Control Group ◽  
Study Group ◽  
The Mean ◽  
Social Security Institute

Background:Connective tissue diseases are more frequent among women in childbearing age. In the past, it was not recommended for these women to get pregnant because of the risk of adverse pregnancy outcomes.Objectives:The aim of this study is to compare the morbidity and mortality between pregnant patients with rheumatic diseases and pregnant patients without rheumatic diseases in El Salvador.Methods:A case control study was conducted atthe Clinic of Pregnancy and Arthritisand the1° de Mayo Hospital, both centers belong to theSalvadoran Social Security Institute. Clinical files were reviewed retrospectively and some of the data were collected during the clinical visit to each center. We included pregnant patients with rheumatic diseases of the Clinic of Pregnancy and Arthritis; the control group was randomly selected with a ratio 1:1 within pregnant patients without rheumatic diseases of the 1° de Mayo Hospital, between January 2016 and June 2019. A complication was defined as any event that required hospital admission. We used logistic regression to analyze univariable and multivariable associations to compare pregnancy outcomes between groups.Results:During the study period, 230 patients were randomly included in both, the study group and the control group, with a ratio 1:1. The mean age for the study group was 32 (27-35) years, which was relatively older than the control group, 28 (24-32) years. The mean pregnancy among both groups was 2 per patient. The most common rheumatic diseases in the study group were Rheumatoid arthritis (39.1%), Antiphospholipid Syndrome (31.3%) and Generalized Lupus Erythematosus (20%). The average visit to the Rheumatologist during pregnancy in the study group was 3.2. The visits started at a mean of 15.2 + 7.6 weeks of gestational age.Thirty three point nine percent (33.9%) of the study group presented complications during pregnancy (vs 20.9%). Among the patients who presented complications, 9 of them (7.8%) had more than one complication during pregnancy. There were 44.3% cesarean deliveries in the study group compared with 22.6% in the control group, OR 2.1 (1.5-4.8) p=0.001. There were 16% of preterm deliveries between 34-37 weeks of gestational age in the study group compared to 10% in the control group, OR 2.2 (0.9-4.8) p=0.063. Preterm deliveries before 34 weeks of gestational age in the study group were 18% compared to 3% in the control group, OR 6.9 (2.3-20-9) p=0.001. There were 6 cases of spontaneous abortion in the study group and none in the control group. Thirty four percent (34%) of cases with low birth weight (<2.5kg) were found in the study group compared to 14% in the control group, OR 3.4 (1.6-6.1) p=0.001.Conclusion:The most common rheumatic diseases among pregnant patients were Rheumatoid Arthritis, Antiphospholipid syndrome and Generalized Lupus Erythematosus.Having a rheumatic disease was more associated with cesarean delivery, preterm delivery between 34 and 37 weeks of gestational age, and low birth weight.References:[1]M. Gayed, C. Gordon. Pregnancy and rheumatic diseases. Rheumatology 2007;46:1634–1640.[2]Y A de Man, et al. Annals of Rheumatic Diseases. 2008. 10.1136Disclosure of Interests:None declared

scholarly journals Outcome of expectantly managed small-for-gestational-age pregnancies with normal Doppler parameters- a prospective cohort study

2021 ◽  
Vol 10 (3) ◽  
pp. 1134
Author(s):  
Sneha Mishra ◽  
Krishna Agarwal
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Gestational Age ◽  
Expectant Management ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Biophysical Profile ◽  
Group 3 ◽  
The Mean

Background: SGA foetuses with normal Dopplers are not at risk of IUD. However, there is lack of consensus about timing of delivery of SGA foetuses. Clinicians commonly induce all SGA pregnancies at 37 weeks. Expectant management of SGA foetuses beyond 37 weeks is not well studied.Methods: We followed up women with clinically suspected growth restriction with foetal biometry, Doppler and biophysical profile. Pregnancies with foetal AC between 10th to 3rd centile with normal Dopplers were recruited in the study group. The women were allowed to go in spontaneous labor till 39+6/7 weeks or were induced at 39+6/7 weeks. The outcome of such cases was compared with controls who were induced at 37+0/7 weeks.Results: Spontaneous labor occurred in 42% subjects in study group whereas in control group all were induced. Mean gestation at delivery in the study group was increased (39.57±0.71 versus 37.0±0.0, p value <0.001). Almost 81% of the subjects in study group delivered after 39 weeks. The rate of caesarean section was significantly lower in study group (3% versus 22%, p value-0.024). Also, the risk of intrapartum foetal distress was lower in study group (3/36 versus 1/36).The mean birth weight in the study group was higher (2426.5±154.1 gm versus 2297.9±101.4 gm, p value <0.001.Conclusions: Expectant management of SGA pregnancies with normal Doppler parameters leads to a significant increase in gestational age at birth and the mean birth weight and a significant reduction in caesarean section rate. 

scholarly journals Pregnancy outcomes in patients with rheumatoid arthritis and systemic lupus erythematosus. Part I. Maternal outcomes

2019 ◽  
Vol 57 (2) ◽  
pp. 180-185 ◽  
Author(s):  
N. M. Kosheleva ◽  
E. V. Matyanova ◽  
E. V. Fedorova ◽  
N. I. Klimenchenko
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Pregnancy Outcomes ◽  
Control Group ◽  
Maternal Outcomes ◽  
Third Trimester ◽  
Systemic Lupus ◽  
Arterial Perfusion

Improved diagnosis and treatment of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) contribute to the remission of the disease and improve the quality of life of patients. In this regard, more and more women with RA and SLE decide to have pregnancy, which makes it actual to study the features of its course and outcomes in these diseases.Objective: to evaluate maternal pregnancy outcomes in patients with RA and SLE.Subjects and methods. 76 cases of pregnancy were traced prospectively in 72 patients: 32 pregnancies in 29 patients with RA and 44 pregnancies in 43 patients with SLE.Results and discussion. 72 of 76 (94.7%) supervised pregnancies ended in childbirth with the birth of a viable baby. There were three cases of pregnancy loss in the second trimester in SLE patients with concomitant antiphospholipid syndrome (AFS) and one case (3.1%) of perinatal infant death (a boy and a girl, monochorionic diamniotic twins with reverse arterial perfusion syndrome) in a patient with seropositive RA. Compared with the all-Russian population, the supervised RA and SLE patients more often had prematurely birth (37.5‰, 18.7% and 22.7%) and caesarean section (CS; in 236.7‰, 50%, and 56.8% respectively). In the SLE group CS was conducted due to the emergency reasons more frequently than in RA, (respectively 47,7% and 25%, relative risk of 1.9 [1; 3.7]; p=0.04). CS at the first birth was performed more often during RA and SLE than before the onset of the disease (p<0.001). Preeclampsia in patients with RA was diagnosed more often than in the population (9.4% and 15.7 per 1000 births, respectively). There was a reverse correlation between the timing of delivery and disease activity according DAS28-CRP in II (r= 0.5; p=0.01) and III (r= 0.6; p=0.0005) trimesters of pregnancy, and in patients with moderate and high activity of RA in the third trimester (n=12) delivery was earlier than in the control group (n=20), remission or low activity of RA (p<0.01). In patients with SLE who had birth prematurely (22.7%), the duration of the disease (p=0.02) and the duration of oral glucocorticoid therapy (p=0.003) were greater compared with SLE patients having term birth (70.5%); the dose of glucocorticoids at the time of conception and delivery did not affect the timing of delivery.Conclusion. Planning of pregnancy in patients with RA and SLE, monitoring during pregnancy and timely correction of therapy contribute to uncomplicated course of gestation and improve maternal outcomes.

Women with chronic hypoparathyroidism have low risk of adverse pregnancy outcomes

2021 ◽  
Author(s):  
Sigridur Björnsdottir ◽  
Bart Clarke ◽  
Outi Mäkitie ◽  
Anna Sandström ◽  
Eleonor Tiblad ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Perinatal Death ◽  
Induction Of Labor ◽  
Control Group ◽  
Drug Register ◽  
Increased Risk ◽  
Infant Birth ◽  
Chronic Hypoparathyroidism

Abstract Objective The aim of this study was to evaluate pregnancy outcome and total number of births in chronic hypoparathyroidism (hypoPT). Patients The Swedish National Patient Register, The Swedish Prescribed Drug Register, Swedish Medical Birth Register and the Total Population Register were used to identify 97 women with chronic hypoPT and 1030 age-matched controls who delivered 139 and 1577 singleton infants, respectively, following diagnosis between 1997 and 2017. Results Women in the chronic hypoPT group had more frequent diabetes (DM) and chronic kidney disease (CKD) compared to women in the control group (p=0.043 and p&lt;0.001, respectively). After adjusting for DM, CKD, maternal age at delivery and calendar year of delivery, chronic hypoPT cases were associated with increased risk of induction of labor (OR 1.82; 95% CI 1.13-2.94) and giving birth to infants with lower birth weight (β-coefficient -188 g; 95% CI -312.2- -63.8) compared to controls. No difference was found in infant length, small for gestational age or head circumference after adjustments. Mean gestational age at delivery after controlling for DM, CKD and pre-eclampsia, was not significantly younger (p=0.119). There was no difference in congenital malformations or perinatal death. There was no difference in the total number of infants born to women with chronic hypoPT and controls (p=0.518). Conclusion The majority of women with chronic hypoPT had normal pregnancy outcomes, and the overall risks appear to be low. Maternal chronic hypoPT, is however, associated with a higher risk of induction of labor and slightly lower infant birth weight.

scholarly journals Successful External Cephalic Version: Factors Predicting Vaginal Birth

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Pei Shan Lim ◽  
Beng Kwang Ng ◽  
Anizah Ali ◽  
Mohamad Nasir Shafiee ◽  
Nirmala Chandralega Kampan ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Gestational Age ◽  
Caesarean Section Rate ◽  
Vaginal Birth ◽  
External Cephalic Version ◽  
Control Group ◽  
Study Group ◽  
Amniotic Fluid Index ◽  
Additional Information ◽  
The Mean

Purpose. To determine the maternal and fetal outcomes of successful external cephalic version (ECV) as well as factors predicting vaginal birth.Methods. The ECV data over a period of three years at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) between 1 September 2008 and 30 September 2010 was reviewed. Sixty-seven patients who had successful ECV were studied and reviewed for maternal, fetal, and labour outcomes. The control group comprised patients with cephalic singletons of matching parity who delivered following the index cases.Results. The mean gestational age at ECV was263±6.52 days (37.5 weeks ± 6.52 days). Spontaneous labour and transient cardiotocographic (CTG) changes were the commonest early adverse effects following ECV. The reversion rate was 7.46%. The mean gestational age at delivery of the two groups was significantly different (P=0.000) with277.9±8.91days and269.9±9.68days in the study group and control groups, respectively. The study group needed significantly more inductions of labour. They required more operative deliveries, had more blood loss at delivery, a higher incidence of meconium-stained liquor, and more cord around the neck. Previous flexed breeches had a threefold increase in caesarean section rate compared to previous extended breeches (44.1% versus 15.2%,P=0.010). On the contrary, an amniotic fluid index (AFI) of 13 or more is significantly associated with a higher rate of vaginal birth (86.8% versus 48.3%,P=0.001).Conclusions. Patients with successful ECV were at higher risk of carrying the pregnancy beyond 40 weeks and needing induction of labour, with a higher rate of caesarean section and higher rates of obstetrics complications. Extended breech and AFI 13 or more were significantly more likely to deliver vaginally postsuccessful ECV. This additional information may be useful to caution a patient with breech that ECV does not bring them to behave exactly like a normal cephalic, so that they have more realistic expectations. However, these predictive factors needed further confirmation and hopefully, in the future, they would be able to further enhance counselling prior to ECV.

scholarly journals Association of gestational age, Apgar score and neonatal outcomes in newborns with meconium stained amniotic fluid

2019 ◽  
Vol 6 (4) ◽  
pp. 1563
Author(s):  
Preeti Garg ◽  
Devendra Barua ◽  
Shruti Saxena
Keyword(s):  
Amniotic Fluid ◽  
Gestational Age ◽  
Apgar Score ◽  
Tertiary Care ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Study Group ◽  
Increased Risk ◽  
The Mean ◽  
Meconium Stained Amniotic Fluid

Background: Infants born with meconium stained fluid are at increased risk of fetal hypoxia, evidenced by increased rates of abnormalities indicated by fetal monitoring in labor, low neonatal Apgar scores, and fetal deaths. The study is conducted to determine association of gestational age, Apgar score and neonatal outcomes in newborn born with meconium stained amniotic fluid in tertiary care centre of central India.Methods: The study was conducted over a period of 2 years from January 2012 to January 2014 in Department of Pediatrics, Sri Aurobindo Medical College and Hospital, Indore, Madhya Pradesh, India. One hundred newborns with meconium stained amniotic fluid (study group) and one hundred newborns with clear amniotic fluids (control group) were studied in this period. Gestational age, Apgar score and neonatal outcomes were compared among two groups.Results: The mean gestational age in study group was 38.89±1.14 weeks and in control group was 38.59±0.99 weeks. The mean Apgar score at 1 min was 5.80±1.59 in study group and in the control group was 7.86±0.35. 32 babies in meconium stained liquor had hypoxia of which 11 had respiratory distress, 11 required mechanical ventilation (MAS 08, sepsis 03), 2 newborns had HIE stage 2 and 5 patients died. The above findings suggest higher gestational age, lower Apgar score and poor neonatal outcomes are associated with meconium stained liquor.Conclusions: The study depicts significant co-relation with higher gestational age, lower Apgar at 1 and 5 minutes and poor neonatal outcome in babies with meconium stained amniotic fluid.

Pregnancy outcomes among women with systemic lupus erythematosus: a retrospective cohort study from Thailand

Lupus ◽  
2017 ◽  
Vol 27 (1) ◽  
pp. 158-164 ◽  
Author(s):  
S Phansenee ◽  
R Sekararithi ◽  
P Jatavan ◽  
T Tongsong
Keyword(s):  
Lupus Erythematosus ◽  
Pregnancy Outcomes ◽  
Medical Records ◽  
Retrospective Cohort ◽  
Control Group ◽  
Chronic Hypertension ◽  
Study Group ◽  
Systemic Lupus ◽  
Adverse Pregnancy ◽  
Active Disease

Objective The objective of this paper is to compare adverse pregnancy outcomes between normal pregnancies and pregnancies with systemic lupus erythematosus (SLE), particularly focusing on uncomplicated SLE with remission. Methods A retrospective cohort study was conducted by accessing the Maternal-Fetal Medicine (MFM) Unit database and the full medical records of the women. The records of singleton pregnancies with SLE and no underlying disease were assigned as the study group and their medical records were reviewed. The low-risk pregnancies were randomly selected as the controls. The adverse pregnancy outcomes were compared between the control group vs women with SLE, control group vs uncomplicated SLE, and between the subgroups within the study group. Results Of 28,003 births during the study period, 1400 controls and 140 pregnancies with SLE were compared. The rates of fetal loss, preterm birth, small-for-date, low birth weight and preeclampsia were significantly higher in the study groups with a relative risk of 5.6 (95% CI: 2.9–10.9), 3.2 (95% CI: 2.5–4.1), 3.5 (95% CI: 2.4–4.9), 4.2 (95% CI: 3.4–5.3) and 2.9 (95% CI: 1.9–4.4), respectively. The increased rates of most adverse outcomes were still noted even in the cases of uncomplicated SLE. Among women with SLE, lupus nephritis, chronic hypertension, antiphospholipid syndrome, active disease at the onset of pregnancies, and proteinuria were significantly associated with such outcomes. Conclusions Pregnancies with SLE, even in uncomplicated cases with remission, increase the risk of poor pregnancy outcomes. The presence of lupus nephritis, chronic hypertension, antiphospholipid syndrome, active disease at the onset of pregnancies, and proteinuria were significantly associated with such outcomes.

Ideational Fluency in Patients with Rheumatoid Arthritis.

2020 ◽  
Vol 16 ◽  
Author(s):  
Janis Mednieks ◽  
Vladimrs Naumovs ◽  
Jurgis Skilters
Keyword(s):  
Rheumatoid Arthritis ◽  
Lupus Erythematosus ◽  
Neuropsychiatric Symptoms ◽  
Conclusive Evidence ◽  
Cognitive Domain ◽  
Average Score ◽  
Control Group ◽  
Study Group ◽  
Significant Difference ◽  
Ideational Fluency

Background: Neuropsychiatric symptoms have been well documented in several systemic inflammatory conditions, e.g. systemic lupus erythematosus (SLE). Increased prevalence of cognitive decline and psychiatric issues has been reported in patients with rheumatoid arthritis (RA). However, there is limited evidence for which exact cognitive domains are affected and to what degree. Aim: To test the performance of cognition in the domain of ideational fluency (Thing Categories Test in particular) in patients with RA and compare the results with the general population and to the results with cognitive and depression screening scores in both groups. Methods: Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder 7 (GAD-7) assessment, Montreal Cognitive Assessment (MoCA), and Thing Categories Test (TCT) were used to evaluate patients with RA, as well as the control group. Results: Twenty patients with RA and 20 controls were tested. 7 and 4 men, and 13 and 16 women in the study and control group, respectively. Average scores in TCT at three minutes were 7.50 (IQR6.0-10.0) and 6.0 (IQR3.0-8.0) for category “blue”; 17.50 (IQR15.0-19.0) and 16.0 (10.0-18.0) for category “round” in the control and study group, respectively. A statistically significant difference was established between the study and the control group in TCT for the category “blue” (p<0.025). The average score for GAD7 was 2.0 (IQR 0.0-5.75) and 3.0 (IQR0.50-6.00) in the control and study group, respectively. The average score for PHQ-9 was 2.0 (IQR0.25-4.75) and 4.0 (IQR2.00-5.50) in the control and study group, respectively. Finally, the average score for the MoCA scale was 27.0 (IQR25.25-28.00) and 26.0 (IQR23.50-28.00) in the control and study group, respectively. Conclusions: Preliminary evidence suggests that RA at least partially affects the cognitive domain of ideational fluency. However, further research with larger experimental groups is needed to provide more conclusive evidence.

scholarly journals AB0814 PREGNANCY COURSE ASSESSMENT IN PATIENTS WITH RHEUMATIC DISEASES COMPARED TO CONTROLS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1431.2-1432
Author(s):  
O. Hamdi ◽  
M. Sellami ◽  
M. Yasmine ◽  
A. Fazaa ◽  
S. Miladi ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Rheumatic Diseases ◽  
Premature Delivery ◽  
Control Group ◽  
Study Group ◽  
Childbearing Age ◽  
Significant Difference ◽  
History Of ◽  
The Mean ◽  
The Impact

Background:Rheumatic diseases such as rheumatoid arthritis (RA) and spondyloarthritis (SA) may occur among women of childbearing age. Adverse events during pregnancy including disease flare, preterm delivery, and neonatal or fetal death have been reported.Objectives:Our aim was to assess the impact of rheumatic diseases on the course of pregnancy.Methods:We conducted a cross-sectional study involving patients with RA (2010 ACR/EULAR criteria) and SA (2009 ASAS criteria) (study group) as well as healthy controls (control group) matched by age and gender. All women included had at least one pregnancy. Data were collected through telephonic interviews. We used the Student t test to compare the study group and the control group.Results:We enrolled 57 patients (30 RA and 27 SA) and 57 controls. The mean age in the study and the control groups were respectively 43.2 ± 8.2 years [26-48] and 37.5 ± 6 years. The mean chronic inflammatory rheumatisms duration was 13.81 ± 6.2 years. A history of primary sterility was found in 3 patients (1 RA and 2 SA) and none in the control group. The mean age during the first pregnancy was significantly higher in the study group (28 ± 6.2 years versus 24 ± 7 years in the control group) (p=0.01). Eight patients (5 RA and 3 SA) had a history of spontaneous miscarriage. A terminated pregnancy was noted in 3 patients (1 RA and 2 SA). Complications during pregnancy in the study group were gestational diabetes (0.3%), premature delivery (0.3), premature rupture of membranes (0.3%), abortion threat (0.3%) and pre-eclampsia (6%). Pregnancy was more associated with complications in the study group (p=0.05). Cesarean section was more used in the study group (28 patients versus 9 in the control group; p= 0.00). The main indications of cesarean section in the study group were macrosomia (11 patients), scar uterus (6 patients), sacroiliitis (4 SA patients), twin pregnancy (2 patients), and undetermined reasons (6 patients). Fetal presentation in the study group was the seat presentation (3%), top presentation (4%), face (2%), and forehead presentation (0.3%) with no significant difference with the control group. Complications of childbirth in the study group were hemorrhage of delivery (10.3%), cord widening (6.6%), perinatal asphyxia (4.9%), and dystocia (1.9%). However, no statistically significant differences were found between the two groups in the prevalence of complications of childbirth. During pregnancy, 5 patients were on salazopyrine, 2 on corticosteroids and, 1 on non-steroidal anti-inflammatories.Conclusion:Our study showed that pregnancies with rheumatic diseases were at increased risk of having maternal complications and adverse neonatal outcomes.Disclosure of Interests:None declared

scholarly journals Level of serum uric acid in patients with preeclampsia compared to controls and its relation to feto-maternal outcome

2019 ◽  
Vol 8 (6) ◽  
pp. 2471
Author(s):  
Ramraj Meena ◽  
Purnima Pachori ◽  
Sandhya Chaudhary ◽  
Chandrakanta .
Keyword(s):  
Uric Acid ◽  
Birth Weight ◽  
Serum Uric Acid ◽  
Gestational Age ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Age Group ◽  
Normal Birth Weight ◽  
Normal Birth

Background: Uric acid is the final product of the purine metabolism in humans. The two final reactions in its production which catalyze the conversion of hypoxanthine to xanthine and the latter to uric acid are catalyzed by the enzyme xanthine oxidoreductase. The role of uric acid in the progression of prediabetes to diabetes has been known. Serum uric acid has been shown to be associated with cardiovascular disease, hypertension, and chronic kidney disease. The present study was done to see the level of uric acid in preeclampsia and  healthy pregnant controls, to relate serum uric acid results to the severity of hypertension and its relation to fetomaternal outcome in patients attending OPD at RMC Ajmer.Methods: 100 cases of preeclampsia of age group between 20-40 year and gestational age ≥28 weeks and 100 normal healthy women with similar gestational age and age group were included in the study and maternal serum uric acid was estimated in both groups.Results: Mean serum uric acid levels in preeclampsia was 7.65±081 mg/dl and 3.21±072 mg/dl in control group. Perinatal complication was more in case group, 74 % were preterm compared to 11% in control group. Mean birth weight in study group was 2.07 kg, of which 24% babies were VLBW 52% were LBW, and 24% babies had normal birth weight, in control group mean birth weight was 2.82 kg. The difference was found to be statistically significant (p value 0.001). In the study group, the MSUA concentration is found higher in LBW and VLBW babies compared to normal birth weight babies.Conclusions: There is a positive correlation between SUA & severity of preeclampsia, and a significant adverse fetal outcome is observed with raised MSUA in preeclamptic patients.

RHEUMATIC DISEASES AND PREGNANCY (LITERATURE REVIEW)

2021 ◽  
Vol 6 (4) ◽  
pp. 11-17
Author(s):  
T. Bondareva
Keyword(s):  
Rheumatoid Arthritis ◽  
Genetic Engineering ◽  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Pregnancy Outcomes ◽  
Axial Spondyloarthritis ◽  
Connective Tissue Diseases ◽  
Systemic Lupus ◽  
Tnf Α ◽  
Inflammatory Drugs

. The problem of pregnancy in rheumatic diseases does not lose its relevance. The most studied is the course of pregnancy in patients with rheumatoid arthritis, systemic lupus erythematosus and axial spondyloarthritis. Observations in other systemic connective tissue diseases are episodic and do not allow us to draw reliable conclusions. The course of the disease itself, as well as the therapy received by patients, can affect pregnancy, starting with the possibility of conception and ending with unfavorable pregnancy outcomes for the mother and fetus. The onset of pregnancy should be planned at the time of remission or minimal activity of the disease. Of particular interest is drug therapy in patients with rheumatic diseases during gestation. This issue has been and remains complex and has not been fully studied due to the fact that any conclusions about the effect of drugs on the fetus are made retrospectively and cannot be the result of a deliberately initiated study. Currently allowed, though with some reservations, during pregnancy drugs are glucocorticoids, non-steroidal anti-inflammatory drugs, hydroxychloroquine and sulfasalazine. The development of genetic engineering has raised the question of the possibility of using genetic engineering basic therapy during gestation. Currently, the largest number of observations is available for TNF-α inhibitors, the use of which is recognized as possible during pregnancy. The presence of rheumatic disease in itself is not an absolute indication for a caesarean section. The question of the method of delivery is decided individually. Pregnant patients with rheumatic diseases should be under regular joint supervision of an obstetrician-gynecologist, rheumatologist and neonatologist

Sign in / Sign up

Export Citation Format

Share Document