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《系统性红斑狼疮和抗磷脂综合征患者的妊娠管理。第一部分:不孕、卵巢保护和孕前评估》。西班牙妇科和产科协会(SEGO)、西班牙内科学会(SEMI)和西班牙风湿病学会(SER)的共识文件。

Pregnancy Control in Patients with Systemic Lupus Erythematosus and Antiphospholipid Syndrome. Part 1: Infertility, Ovarian Preservation and Preconception Assessment. Consensus Document of the Spanish Society of Gynaecology and Obstetrics (SEGO), the Spanish Society of Internal Medicine (SEMI) and the Spanish Society of Rheumatology (SER).

机构信息

Department of Autoimmune Diseases, Hospital Clinic, Biological aggresion and response mechanisms, IDIBAPS, Universitat de Barcelona, Barcelona, España.

Servicio de Reumatología, Hospital Universitario 12 de Octubre, Madrid, España.

出版信息

Reumatol Clin (Engl Ed). 2021 Feb;17(2):61-66. doi: 10.1016/j.reuma.2019.09.002. Epub 2019 Nov 26.

Abstract

OBJECTIVE

Pregnancy and puerperium are considered a risk situation in women with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). Therefore, specialized assessment is essential both preconception and during pregnancy and the puerperium. Likewise, it is very important that different specialists in autoimmune diseases and high-risk pregnancies participate in the follow-up of these patients in a coordinated manner. The Spanish Society of Gynaecology and Obstetrics, the Spanish Society of Internal Medicine, and the Spanish Society of Rheumatology have set up a working group for the preparation of three consensus documents.

METHODS

The stages of the work were: distribution of work in three groups corresponding to the three periods related to pregnancy (preconception, during pregnancy and childbirth and puerperium), identification of key areas, exhaustive review of the literature and formulation of recommendations.

RESULTS

This first document includes the 48 recommendations that address aspects related to infertility, the need for and treatments for gonadal preservation and preconception assessment.

CONCLUSIONS

These multidisciplinary recommendations are considered decision-making tools for clinicians involved in the care of patients with SLE/APS during pregnancy.

摘要

目的

妊娠和产褥期被认为是系统性红斑狼疮(SLE)和抗磷脂综合征(APS)女性的危险情况。因此,在妊娠前和妊娠期间以及产褥期进行专门评估至关重要。同样,自身免疫性疾病和高危妊娠的不同专家以协调的方式参与这些患者的随访也非常重要。西班牙妇科和产科协会、西班牙内科学会和西班牙风湿病学会成立了一个工作组,负责编写三份共识文件。

方法

这项工作分为三个阶段:对应妊娠相关三个时期(妊娠前、妊娠期间和分娩及产褥期)的三组分配工作、确定关键领域、全面审查文献和制定建议。

结果

这份第一份文件包含了 48 条建议,涉及与不孕、性腺保存的必要性和治疗以及妊娠前评估相关的方面。

结论

这些多学科建议被认为是参与妊娠期间 SLE/APS 患者护理的临床医生的决策工具。

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