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Rheumatology Advance Access published online on July 10, 2007
Rheumatology, doi:10.1093/rheumatology/kem156
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© The Author 2007. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Review

Pregnancy and rheumatic diseases

M. Gayed1,2 and C. Gordon1,2,3

1Department of Rheumatology, Division of Immunity and Infection, The Medical School University of Birmingham, Birmingham B15 2TT, 2Department of Rheumatology, City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham B18 7QH and 3Department of Rheumatology, Queen Elizabeth Hospital, University Hospital Birmingham Foundation NHS Trust, Birmingham B15 2TS, UK

Correspondence to: Dr Caroline Gordon, MA MD FRCP, Department of Rheumatology, Division of Immunity and Infection (East Wing), The Medical School, University of Birmingham, Birmingham B15 2TT, UK. E-mail: p.c.gordon{at}bham.ac.uk


  Abstract

Pregnancy is an issue that should be discussed with all patients with rheumatic diseases who are in the reproductive age group. Infertility is rarely due to the disease but can be associated with cyclophosphamide therapy. Most rheumatic diseases that are well controlled prior to pregnancy do not deteriorate in pregnancy, providing that the patient continues with appropriate disease-modifying therapy. Some patients with inflammatory arthritis go in to remission during pregnancy. Patients with renal involvement may be at increased risk of disease flare. This needs to be distinguished from pre-eclampsia. Intrauterine growth restriction is more likely in patients with active systemic disease, hypertension, a history of thrombosis and renal involvement. Premature delivery may need to be planned to reduce the risks of stillbirth and can be associated with a variety of neonatal complications. Post-partum flare is common in all the rheumatic diseases.

KEY WORDS: Pregnancy, Rheumatoid arthritis, Lupus, Systemic sclerosis, Vasculitis

Submitted 21 January 2007; revised version accepted 18 May 2007.
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