Autoimmunity in obstetrics, and Autoimmune Diseases in Pregnancy

Publication date: Available online 18 March 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): De Carolis Sara, Moresi Sascia, Rizzo Francesca, Monteleone Giuseppina, Tabacco Sara, Salvi Silvia, Garufi Cristina, Lanzone AntonioAbstractAutoimmune diseases (AIDs) are associated with strong female preponderance and often present before or during the reproductive years, consequently pregnancy and breastfeeding are topics of major interest for these patients. AIDs show different response to pregnancy: some ameliorate, other remain unchanged and several AIDs aggravate. The response of the AIDs to the hormonal and immunological alterations of pregnancy reflect the different pathophysiology of each disease. Systemic lupus erythematosus (SLE) and antiphosholipid syndrome (APS) are associated with multiple autoantibodies, multi-organ involvement, more aggressive therapy and increased impact on pregnancy outcome. For the management of pregnancy in SLE and/or APS patients, it is important to individuate the correct risk profile for each woman and timing for treatment. The optimal timing for starting or modulating treatment is at preconception assessment in order to influence the placentation. In this chapter, we will discuss the management of pregnancy in patients suffering AIDs.
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - Category: OBGYN Source Type: research