Main description:

Rheumatic and autoimmune diseases are often present in women during the childbearing years and as such, correct management of pregnancy throughout its course is of significance to all those affected. Previously women with systemic rheumatic diseases were counselled against pregnancy as the majority of medications carried potential or perceived teratogenic risk. But in recent years new therapies have emerged that have advanced treatment. Patients have experienced
significant improvements in physical function, quality of life, and reduced damage accrual. As a result, an expanded cadre of health care providers now need to be able to manage pregnancy in women with underlying rheumatic disease, both in acute or chronic settings.

Practical Management of the Pregnant Patient with Rheumatic Disease is a quick-access guide of the most up-to-date understanding of the interplay between pregnancy and rheumatic diseases and principles of management before, during and after pregnancy assisting in decision making regarding treatment of women with autoimmune diseases.

This collection of 70 cases covers pregnancy counseling, the management of disease flares, thromboembolic disease, the management of patients with end organ disease, advice on medications, obstetric complications, infections and the management of rare diseases in women with rheumatic diseases before and during pregnancy and post-partum.

The handbook provides concise recommendations for all providers who may encounter women of child-bearing age including rheumatologists, gynaecologists, paediatricians, primary care providers and health professionals dealing with pre-conceptional and pregnant women with rheumatic diseases.

Contents:

Section One: Counselling
1: Monika Ostensen: Important points of pre-pregnancy counselling
Section Two: Patients with pre-pregnancy complications
2.1: Andrew James Doyle and Beverley Jane Hunt: Thrombotic Complications in pregnant patients with rheumatic disease
2.2: Roseann O'Doherty and Fionnuala Ni Ainle: Prevention of postpartum venous thromboembolism (VTE)
2.3: Eliza Chakravarty: Pulmonary Arterial Hypertension
2.4: Hannah Blakey and Kate Bramham: Advanced renal disease / renal impairment
2.5: Massimo Radin, Karen Schreiber, and Savino Sciascia: Antibodies as risk factors for adverse maternal and fetal outcomes
Section Three: Adjustment of therapy before/during pregnancy and lactation
3.1: Monika Ostensen and Ian Giles: Disease modifying drugs, biological drugs and concomitant medications before/during pregnancy and lactation
3.2: Christof Schaefer: Managing a patient exposed to a teratogenic drug at different stages of pregnancy
Section Four: Infection during pregnancy
4: Maria Rhona G. Bergantin and Sandra V. Navarra: Infection in a pregnant patient on immunosuppressive treatment
Section Five: Organ specific flares during pregnancy
5: Bonnie L. Bermas and Eliza Chakravarty: Managing Organ Specific Flares
Section Six: Obstetric complications in women with autoimmune diseases
6: D. Ware Branch: Pregnancy and Obstetric Complications in Women with Autoimmune Diseases
Section Seven: Vaccination before or during pregnancy
7: Cara D Varley and Kevin L Winthrop: Vaccination before or during pregnancy
Section Eight: Rare diseases in pregnancy
8.1: Karen Schreiber and Monika Ostensen: SLE
8.2: Karen Schreiber and Soeren Jacobsen: Systemic lupus erythematosus and the risk of cardiovascular disease
8.3: Karen Schreiber and Savino Sciascia: 3 Antiphospholipid syndrome
8.4: Megan Clowse and Jon Golenbiewski: Vasculitis in Pregnancy
8.5: Eliza Chakravarty: Systemic sclerosis
8.6: Muhammed Shipa and David Isenberg: Myositis and Pregnancy
8.7: Monika Ostensen: Ankylosing spondylitis in pregnancy