Management of autoimmune rheumatic diseases during pregnancy

Förger, F (2011). Management of autoimmune rheumatic diseases during pregnancy. Nephrologe, 6(3), pp. 277-287. Springer-Verlag

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Pregnancy is an exceptional state of natural immunomodulation which protects the fetus against the immunological attack by the maternal immune system. The mechanisms of pregnancy-related tolerance may have a positive or negative effect on autoimmune rheumatic diseases. The majority of patients with rheumatoid arthritis experience an improvement in the disease during pregnancy whereas in most ankylosing spondylitis patients the inflammatory back pain remains unchanged. Connective tissue diseases or vasculitis pose a threat to the well-being of both mother and fetus particularly when the activity of the disease is high. In general, pregnancy in patients with rheumatic diseases should be planned in a phase of quiescent disease. Medication compatible with pregnancy should be tailored for the individual patients according to disease activity. A close interdisciplinary observation of these patients is the key for successful pregnancy outcome.

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