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炎症性风湿病患者的妊娠管理。

Managing pregnancy in inflammatory rheumatological diseases.

机构信息

Rheumatology Department, City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Dudley Road, Birmingham B187QH, UK.

出版信息

Arthritis Res Ther. 2011 Feb 25;13(1):206. doi: 10.1186/ar3227.

Abstract

Historically, pregnancy in women with many inflammatory rheumatic diseases was not considered safe and was discouraged. Combined care allows these pregnancies to be managed optimally, with the majority of outcomes being favorable. Disease activity at the time of conception and anti-phospholipid antibodies are responsible for most complications. Disease flares, pre-eclampsia, and thrombosis are the main maternal complications, whereas fetal loss and intrauterine growth restriction are the main fetal complications. Antirheumatic drugs used during pregnancy and lactation to control disease activity are corticosteroids, hydroxychloroquine, sulphasalzine, and azathioprine. Vaginal delivery is possible in most circumstances, with cesarean section being reserved for complications.

摘要

从历史上看,患有多种炎症性风湿病的女性怀孕并不被认为是安全的,因此不被鼓励。联合治疗可以使这些妊娠得到最佳管理,大多数结果都是有利的。受孕时的疾病活动度和抗磷脂抗体是大多数并发症的原因。疾病发作、子痫前期和血栓形成是主要的母体并发症,而胎儿丢失和宫内生长受限是主要的胎儿并发症。用于控制疾病活动度的在妊娠期和哺乳期使用的抗风湿药物有皮质类固醇、羟氯喹、柳氮磺胺吡啶和硫唑嘌呤。大多数情况下可以进行阴道分娩,只有在出现并发症时才会选择剖宫产。

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