Risk Assessment and Optimization for Pregnancy in Patients with Rheumatic Diseases
Abstract
:1. Introduction
2. Screening
2.1. How Often Should We Discuss Reproductive Health? How Do We Begin?
2.2. How Do I Prevent Pregnancy If I’m Not Ready to Become Pregnant Anytime Soon or If I’m on a Teratogenic Medication?
3. Fertility
3.1. Is Female Fertility Affected by Rheumatic Disease?
3.2. Is Male Fertility Affected by Rheumatic Disease?
4. Planning for Pregnancy
4.1. What Can I Do to Reduce the Risk of Bad Outcomes?
4.2. Are There Special Lab Tests I Should Get?
4.3. What Other Monitoring Do I Need?
4.4. Should I Take a Baby Aspirin during My Pregnancy?
4.5. Do I Need a Blood Thinner during Pregnancy?
4.6. If I Want to Become Pregnant, Do I Need to Stop My Medications before I Try to Conceive? If So, When?
4.6.1. Teratogens
4.6.2. Other DMARDs
4.6.3. NSAIDs
4.6.4. Glucocorticoids
4.6.5. Anticoagulation, Antihypertensives, and Vasodilators
4.7. If I Am a Male with Rheumatic Disease Planning Pregnancy with a Birthing Partner, Do I Need to Stop My Medications? If So, When?
5. Pregnancy and Neonatal Outcomes
5.1. Is There a Greater Risk for Miscarriage or Perinatal Death (Which Includes Stillbirth and Neonatal Death)?
5.2. What Is the Likelihood of Other Pregnancy Complications?
5.3. Is It Safe to Continue Biologics during Pregnancy?
5.4. Is It Safe to Continue Other DMARDs or Anti-Rheumatic Drugs during Pregnancy?
5.5. Are Vaccinations for My Child Going to Be Less Effective If I Took a Biologic or Small-Molecule DMARD While Pregnant?
5.6. What Long-Term Developmental Risks for My Child Have Been Studied?
5.7. What Is the Likelihood My Child Will Get My Disease?
6. Maternal Outcomes
6.1. What Is the Likelihood My Disease Will Flare While I’m Pregnant?
6.2. If I Do Experience a Flare, What Medications Can I Take?
6.3. Do I Need Stress-Dose Steroids?
6.4. Am I at Risk for Any Complications?
7. Postpartum
7.1. Are My Meds Still Going to Work If I Stopped Them during Pregnancy?
7.2. Which Medications Are Safe in Breastfeeding?
8. Conclusions
Funding
Acknowledgments
Conflicts of Interest
References
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Kwok, A. Risk Assessment and Optimization for Pregnancy in Patients with Rheumatic Diseases. Diagnostics 2024, 14, 1414. https://doi.org/10.3390/diagnostics14131414
Kwok A. Risk Assessment and Optimization for Pregnancy in Patients with Rheumatic Diseases. Diagnostics. 2024; 14(13):1414. https://doi.org/10.3390/diagnostics14131414
Chicago/Turabian StyleKwok, Alyssa. 2024. "Risk Assessment and Optimization for Pregnancy in Patients with Rheumatic Diseases" Diagnostics 14, no. 13: 1414. https://doi.org/10.3390/diagnostics14131414