EULAR 2019: Pregnant issues in patients with rheumatic diseases

Dr. Nelson-Piercy, gynecologist from the UK, very elegantly explained the gynecologist’s perspective of pregnant issues in patients with rheumatic diseases. How needs reproductive health counseling? Everybody! Every patient with a rheumatic disease needs and should be offered a counseling session about their reproductive health. BelowI will try to summarize key messages to do this properly. I would like to begin this section quoting Dr. Nelson-Piercy: “More harm comes to the mothers from active disease than from medication treating active disease”. Usually when we talk about this topic among colleagues we focus on the effect of medication and their potential teratogenic effects. Now, it is clear that mothers want to get answers to other interesting questions: What is the effect of disease on pregnancy outcomes? What is the effect of medication on pregnancy outcomes? What is the effect of pregnancy on disease? Firstly, there is solid evidence available that disease activity in RA and SLE is associated with worse pregnancy outcomes, mainly preterm delivery. Mothers should be informed in depth about this possibility and we should explain what…