Skip to main content Accessibility help
×
Hostname: page-component-76fb5796d-9pm4c Total loading time: 0 Render date: 2024-04-27T06:02:04.825Z Has data issue: false hasContentIssue false

Chapter 35 - Autoimmune disease in pregnancy

from Section 4 - The pregnant patient with coexisting disease

Published online by Cambridge University Press:  05 July 2013

Marc van de Velde
Affiliation:
University Hospital Leuven
Helen Scholefield
Affiliation:
Liverpool Women's Hospital
Lauren A. Plante
Affiliation:
Drexel University College of Medicine
Get access

Summary

Pregnancy is associated with a dramatic increase in estrogen and other hormones; consequently, there is the potential for autoimmune disease to worsen during pregnancy. Systemic lupus erythematosus (SLE), lupus nephritis, antiphospholipid syndrome (APS), systemic sclerosis, myasthenia gravis, idiopathic thrombocytopenic purpura (ITP), rheumatoid arthritis, and adrenal crisis are some of autoimmune disorders. This chapter discusses their complications and subsequent management during pregnancy. Flares due to SLE during pregnancy can be treated with hydroxychloroquine and corticosteroids. Hydroxychloroquine, specific complement inhibitors, and tumor necrosis-alpha inhibitors are being evaluated as potential therapies for APS. The first-line therapy for ITP during pregnancy is corticosteroids, typically prednisone. The cornerstone of treatment of myasthenic crisis is to remove circulating antibodies via plasma exchange or to inactivate these antibodies with Intravenous immunoglobulin (IVIG), which are both considered to be safe in pregnancy. Aggressive hydration and glucose replacement are advised for adrenal crisis.
Type
Chapter
Information
Maternal Critical Care
A Multidisciplinary Approach
, pp. 391 - 402
Publisher: Cambridge University Press
Print publication year: 2013

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×