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Maternal autoimmune disorders 

Maternal autoimmune disorders
Chapter:
Maternal autoimmune disorders
Author(s):

Harini Narayan

DOI:
10.1093/med/9780199673643.003.0013
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date: 07 June 2020

This chapter includes autoimmune conditions which have special relevance for pregnancy, especially lupus, antiphospholipid syndrome, anti-Ro antibodies, rheumatoid arthritis, Sjögren’s syndrome, dermatomyositis, and polymyositis. Epidemiology, complex and varied manifestations, diagnostic criteria, maternal and fetal outcomes, the impact of pregnancy on these conditions and vice versa are described. Individual fact files and care pathways for effective multidisciplinary management are provided for each condition, based on national and international guidelines, up-to-date literature, and best practice evidence. Pre-pregnancy assessment and preparation for pregnancy, essential investigations and ongoing materno-fetal monitoring and assessment are described. Medications including antihypertensives, disease-modifying agents, aspirin, LMWH, or steroids used for symptom control or for prophylaxis are discussed, as are drugs contraindicated in pregnancy and lactation. Documentation and the communication of key information for intrapartum and neonatal care are detailed, especially where there is an increased risk of neonatal lupus or heart block. Patient information is provided for each condition.

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