Multidisciplinary approach in the management of pregnancy and rheumatic diseases – the challenges for obstetricians and gynecologists

Abstract

Rheumatic diseases (RD) primarily affect young women of reproductive age and therefore pregnancy in these patients requires more attention. Pregnancy in women with RD requires a multidisciplinary, carefully coordinated approach before, during and after pregnancy to ensure the best possible prognosis for the mother and the baby. Treatment of patients with RD during pregnancy and in the post-natal period may be a major challenge for both rheumatologists and obstetrics-gynaecologists. Risk stratification and pregnancy planning are key to ensuring normal pregnancy in women with RD and minimal risk of complications. On the other hand, the risks to the fetus are related to the activity of the mother's disease, presence of specific autoantibodies, and mother's therapy. It is of great importance to stabilize the disease, to replace the medication with pregnancy-compatible drugs, tests of the autoantibody status and organ damage assessment. For these reasons, active monitoring of pregnant women with RD should be carried out by rheumatologist and gynecologist.