Pregnancy in patients with rheumatic disease is an important and well-recognized problem. The conception is recommended if patient is in clinical remission and pharmacological burden is minimal at least 3 months prior to the conception. There is often a clinical improvement in early pregnancy. Risk factors of complicated pregnancy include persistent high disease activity and positive ACCP. rheumatoid diseases (RA) does not affect fertility directly, decreased fertility is observed in case of comorbidity (APLS) or some medications. The pregnancy is uncomplicated in inactive RA and results in natural childbirth. Risk factors of complicated delivery include presence of Ro-SSA/La-SSB and anti-phospholipid antibodies. Provided are some general recommenda-tions on pharmacotherapy of patients with RA planning pregnancy. The most commonly used disease-modifying antirheumatic drugs and immunosuppressants are reviewed peripartum and postpartum. Safety for the child is determined by the drug concentration in the milk of breastfeeding mother. Suggested here is a plan on how to manage a rheumatic disease during pregnancy.
rheumatic diseases, pregnancy, risk factors, immunosuppressants, biological therapy.
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