TY - JOUR
T1 - Challenging cases in rheumatic pregnancies
AU - Edens, Cuoghi
AU - Rodrigues, Bruna Costa
AU - Lacerda, Marcela Ignacchiti
AU - Dos Santos, Flavia Cunha
AU - De Jesús, Guilherme R.
AU - De Jesús, Nilson Ramires
AU - Levy, Roger A.
AU - Leatherwood, Cianna
AU - Mandel, Jess
AU - Bermas, Bonnie
N1 - Funding Information:
Funding: This work was supported by the National Institutes of Health (R13AR070007).
Publisher Copyright:
© 2018 The Author(s). All rights reserved.
PY - 2018/7/1
Y1 - 2018/7/1
N2 - This article describes three complicated cases in rheumatology and pregnancy. The first case elucidates the challenges in treating SLE in conjunction with pulmonary arterial hypertension, while the second case features an SLE-affected pregnancy with development of portal hypertension secondary to portal vein thrombosis related to APS. The third case is a pregnant woman 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. There are grave and unique challenges for women with autoimmune disease, but 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.
AB - This article describes three complicated cases in rheumatology and pregnancy. The first case elucidates the challenges in treating SLE in conjunction with pulmonary arterial hypertension, while the second case features an SLE-affected pregnancy with development of portal hypertension secondary to portal vein thrombosis related to APS. The third case is a pregnant woman 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. There are grave and unique challenges for women with autoimmune disease, but 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.
KW - anti-phospholipid syndrome
KW - portal hypertension
KW - portal vein thrombosis
KW - pregnancy
KW - pulmonary arterial hypertension
KW - scleroderma
KW - stillbirth
KW - systemic lupus erythematosus
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U2 - 10.1093/rheumatology/key172
DO - 10.1093/rheumatology/key172
M3 - Review article
C2 - 30137591
AN - SCOPUS:85052561081
SN - 1462-0324
VL - 57
SP - V18-V25
JO - Rheumatology (United Kingdom)
JF - Rheumatology (United Kingdom)
ER -