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Fertility, pregnancy, and relationships 

Fertility, pregnancy, and relationships
Chapter:
Fertility, pregnancy, and relationships
DOI:
10.1093/med/9780198831426.003.0014
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date: 08 May 2021

Fertility, contraception, and ongoing management of those who are pregnant and have a long-term musculoskeletal condition (MSC) are discussed in this chapter. Many of the challenges facing health professionals caring for those with a MSC involve ensuring the patient and the unborn child remain safe and yet the disease is effectively controlled using various treatment options. This chapter provides an approach that considers counselling and preparing the patients before conception, particularly for issues such as timing of a pregnancy, drug management to achieve safe disease control, and fertility issues that may challenge opportunities for conception. Once a safe birth is achieved, the ongoing management, particularly considering medications and breastfeeding, is outlined. There is a specific focus on those MSCs that are long-term conditions and have additional risks related to fertility and pregnancy, e.g. systemic lupus erythematosus and primary systemic vasculitis. Finally, there is a section focused on how self-esteem, relationships, and sexuality can be affected by a long-term MSC and which offers guidance on ways to help patients.

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