Rheumatic Pregnancies: The Challenging Cases

Getting pregnant is usually a very exciting and happy time, but if the pregnant woman has rheumatic diseases, there can be some issues that can arise. According to the American College of Rheumatology (ACR) diseases with the potential to affect the kidneys, especially lupus and antiphospholipid syndrome (APS), are more likely to affect pregnancy outcome than others. In an article published in Rheumatology, researchers review three complicated cases in rheumatology and pregnancy. 

3 complicated cases in rheumatology and pregnancy https://t.co/nuAQ6BKih1
– Lupus + pulmonary arterial hypertension
– Lupus + portal vein thrombosis (Antiphospholipid)
– Lupus + thrombotic microangiopathy
Published in @RheumJnl pic.twitter.com/GUE4fTB4Pc

— Juan Ovalles MD, PhD (@DrJuanOvalles) September 17, 2018

In this article, researchers look at one case with pregnancy and the challenges in treating systemic lupus erythematosus (SLE) in conjunction with pulmonary arterial hypertension. The second case was focused on SLE-affected pregnancy with development of portal hypertension secondary to portal vein thrombosis related to antiphospholipid syndrome (APS). The third case reviews a woman pregnant and with stable SLE who developed thrombotic microangiopathy caused by atypical haemolytic uraemic syndrome and failed to improve despite multiple measures including biopsy and elective preterm delivery. 

Geesh. Check out these remarkable (scary) cases. This job 🤦‍♂️

Challenging cases in rheumatic pregnancies | Rheumatology | Oxford Academic https://t.co/4dSfIJZVVR

— Jason S Knight (@jasonsknight) August 31, 2018

These types of issues can be very challenging to work with for rheumatologists and their patients, but researchers stated that “adverse outcomes can sometimes be avoided with careful and multidisciplinary medical management.” 

“Pre-conception counselling with regard to medications and disease treatment should also include discussion of the advisability of pregnancy, which may be difficult for a patient, but present the best course for optimizing health outcomes,” the authors of the study added. 

Check out an article on the results from the TRIO study on total knee arthroplasty (TKA). 

SOURCE: Rheumatology