Rheumatological diseases

Abstract

Pregnancy is a delicate situation for women with systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), or other systemic autoimmune disease. Several adaptations occur in a woman's immune system during pregnancy in order to maintain her defense capacity and at the same time to protect the fetus from immune rejection. Further, it is essential to assess the influence of the disease and its treatment on the pregnant woman and the fetus. Pregnancy in systemic autoimmune disease patients must be planned, which means that the patient must use contraception until the disease is well controlled and used medication that are appropriate for conception and pregnancy. Although adverse pregnancy outcomes occur, a better understanding of the diseases and the improvement of treatment before and during pregnancy have resulted in a reduction in pregnancy losses and maternal morbidity in recent decades. Some medications used to treat autoimmune diseases are contraindicated during pregnancy and should be replaced as soon as possible if pregnancy is not planned. There should be great interaction of obstetric and rheumatologic teams that are responsible for the patient and the decisions must be taken together for a best results as possible.