Reproductive health and pregnancy problems of systemic lupus erythematosus

Authors

DOI:

https://doi.org/10.18370/2309-4117.2019.50.56-64

Keywords:

systemic lupus erythematosus, pregnancy, contraception, lupus nephritis, antiphospholipid antibodies

Abstract

Nowadays, the majority of young women with systemic lupus erythematosus (SLE) can successfully become pregnant, carry pregnancy to term and give birth to a healthy child due to improved therapeutic approaches and consequently reduction in morbidity and mortality. Pregnancy outcomes in these women have also improved significantly over the past decades. Correct timing of conception (taking into account disease activity and target organ damage), careful monitoring of patients for three trimesters and the postpartum period (to timely identify and treat possible obstetric complications or maternal disease flares), as well as the concept of multidisciplinary management, are currently the main points of SLE patients of reproductive age. Growing knowledge about the compatibility of drugs with pregnancy has improved treatment approaches for these patients, which allows controlling maternal disease without harming the fetus.

Particular attention and strict monitoring should be dedicated to SLE pregnant women in particular clinical settings: patients with lupus nephritis, patients with a positive titer of antiphospholipid antibodies, antiphospholipid syndrome, and patients with Ro/SSA and/or La/SSB antibodies. Family planning discussions and contraceptive counseling should be part of everyday practice for doctors who observe women with SLE at reproductive age. Another problem is the possible decrease in fertility in these women, which may be due to different reasons. As a result, in recent years, the demand for assisted reproduction methods has increased, so rheumatologists and gynecologists should be ready to advise patients with SLE in this situation. This literature review is based on the evidence-based recommendations on family planning management and women's health issues in SLE and/or antiphospholipid syndrome developed by a multidisciplinary group of experts of the European League Against Rheumatism in 2017.

Author Biographies

И. Ю. Головач, Rheumatology Center of the «Feofaniya» of the Clinical hospital State Management of Affairs, Kyiv

MD, professor, head of Rheumatology Center

Е. Д. Егудина, SI “Dnipropetrovsk Medical Academy of the MoH of Ukraine”, Dnipro

MD, professor, associate professor of the Internal Medicine Department No 3

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Published

2019-12-28

How to Cite

Головач, И. Ю., & Егудина, Е. Д. (2019). Reproductive health and pregnancy problems of systemic lupus erythematosus. REPRODUCTIVE ENDOCRINOLOGY, (50), 56–64. https://doi.org/10.18370/2309-4117.2019.50.56-64

Issue

No. 50 (2019)

Section

Interdisciplinary consilium

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Copyright (c) 2019 И. Ю. Головач, Е. Д. Егудина

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