| Management of rheumatic diseases during pregnancy. | |
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MedLine Citation:
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PMID: 20463432 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Systemic rheumatic diseases commonly affect women during the childbearing years. Many women with these diseases may be contemplating pregnancy or discover an inadvertent pregnancy, leading to concerns regarding medication use, changes in disease activity during pregnancy, safety of lactation, and future ability to care for a child given the presence of chronic illnesses. There are outstanding reviews that summarize the safety and use of immunosuppressive medications during pregnancy. However, in addition to medication use, providers need to be aware of the available data regarding fertility, pregnancy outcomes, delivery, and lactation issues that may be specific to individual diseases. Optimally, women should plan pregnancies to occur around times of disease quiescence, several months after potentially teratogenic medications have been discontinued. The course of the underlying rheumatic disease during pregnancy is variable, and there are no specific clinical or laboratory variables that consistently predict disease improvement or worsening during pregnancy. Recent data suggest that increased disease activity in women with most autoimmune diseases during pregnancy may lead to increased risk of premature delivery, low-birth-weight infants, and other adverse pregnancy outcomes. Arthritis involving the cervical spine and hips may impact delivery and must be considered by both obstetricians and obstetric anesthesiologists. Data are mixed regarding the impact of breastfeeding on underlying autoimmune diseases; the choice to continue breastfeeding is a personal decision. |
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Authors:
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Amy B Elliott; Eliza F Chakravarty |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Postgraduate medicine Volume: 122 ISSN: 1941-9260 ISO Abbreviation: Postgrad Med Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-05-13 Completed Date: 2010-06-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0401147 Medline TA: Postgrad Med Country: United States |
Other Details:
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Languages: eng Pagination: 213-21 Citation Subset: AIM; IM |
Affiliation:
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Division of Immunology and Rheumatology, Stanford University School of Medicine, Palo Alto, CA 94304, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Antirheumatic Agents
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adverse effects Breast Feeding Delivery, Obstetric Female Humans Preconception Care* Pregnancy Pregnancy Complications / drug therapy* Pregnancy Outcome Rheumatic Diseases / complications, drug therapy* |
| Chemical | |
Reg. No./Substance:
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0/Antirheumatic Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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