Gayed M, Gordon C
Department of Rheumatology, Division of Immunity and Infection (East Wing), The Medical School University of Birmingham, Birmingham B15 2TT, UK.
Rheumatology (Oxford). 2007 Nov;46(11):1634-40. doi: 10.1093/rheumatology/kem156. Epub 2007 Jul 10.
Pregnancy is an issue that should be discussed with all patients with rheumatic diseases who are in the reproductive age group. Infertility is rarely due to the disease but can be associated with cyclophosphamide therapy. Most rheumatic diseases that are well controlled prior to pregnancy do not deteriorate in pregnancy, providing that the patient continues with appropriate disease-modifying therapy. Some patients with inflammatory arthritis go in to remission during pregnancy. Patients with renal involvement may be at increased risk of disease flare. This needs to be distinguished from pre-eclampsia. Intrauterine growth restriction is more likely in patients with active systemic disease, hypertension, a history of thrombosis and renal involvement. Premature delivery may need to be planned to reduce the risks of stillbirth and can be associated with a variety of neonatal complications. Post-partum flare is common in all the rheumatic diseases.
妊娠是一个应该与所有处于育龄期的风湿性疾病患者讨论的问题。不孕症很少由疾病本身导致，但可能与环磷酰胺治疗有关。大多数在妊娠前病情得到良好控制的风湿性疾病，只要患者继续接受适当的病情缓解治疗，在孕期病情不会恶化。一些炎性关节炎患者在孕期病情会缓解。有肾脏受累的患者疾病复发风险可能增加。这需要与子痫前期相鉴别。患有活动性全身性疾病、高血压、有血栓形成史和肾脏受累的患者发生宫内生长受限的可能性更大。可能需要计划早产以降低死产风险，并且早产可能伴有多种新生儿并发症。产后病情复发在所有风湿性疾病中都很常见。
