The medical management of the rheumatology patient during pregnancy

Research output: Chapter in Book/Report/Conference proceedingChapter

1 Citation (Scopus)

Abstract

Decisions regarding medication use during pregnancy are amongst the most challenging clinicians will face. The health of both the mother and the developing fetus must be taken into account when designing a treatment plan. Limited data on an individual drug's risk for use during pregnancy and conflicting recommendations regarding drug safety contribute to uncertainty in therapy choices. Clinicians and patients individually have their own risk tolerance for prescribing and taking medications. Finally, pregnancy itself can impact an individual patient's disease activity rendering typical treatment approaches invalid. This chapter will discuss the treatment of the pregnant and nursing woman with a rheumatic disease. It will review the literature on commonly used medications for rheumatic disease management including aspirin, the nonsteroidal anti-inflammatory medications and COX-2 inhibitors; the glucocorticoids; the antimalarials; sulfasalazine; the immunosuppressive agents azathioprine and 6-mercaptopurine, cyclosporine, mycophenolate mofetil, and tacrolimus; the anti-metabolite methotrexate; leflunomide; cylophosphamide; intravenous immunoglobulin; the biologics including tumor necrosis factor-α (TNF-α) blockers, rituximab, belimumab, actemra, anakinra, abatacept, and tocilizumab; the anti-coagulants warfarin and unfractionated and fractionated heparin and colchicine. Wherever possible, specific recommendations will be made.

Original languageEnglish (US)
Title of host publicationContraception and Pregnancy in Patients with Rheumatic Disease
PublisherSpringer New York
Pages273-287
Number of pages15
ISBN (Electronic)9781493906734
ISBN (Print)1493906720, 9781493906727
DOIs
StatePublished - Mar 1 2014

Fingerprint

Rheumatology
Pregnancy
leflunomide
Rheumatic Diseases
Interleukin 1 Receptor Antagonist Protein
Mycophenolic Acid
6-Mercaptopurine
Sulfasalazine
Coagulants
Cyclooxygenase 2 Inhibitors
Intravenous Immunoglobulins
Azathioprine
Colchicine
Antimalarials
Tacrolimus
Warfarin
Therapeutics
Immunosuppressive Agents
Disease Management
Biological Products

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Bermas, B. L. (2014). The medical management of the rheumatology patient during pregnancy. In Contraception and Pregnancy in Patients with Rheumatic Disease (pp. 273-287). Springer New York. https://doi.org/10.1007/978-1-4939-0673-4_14

The medical management of the rheumatology patient during pregnancy. / Bermas, Bonnie L.

Contraception and Pregnancy in Patients with Rheumatic Disease. Springer New York, 2014. p. 273-287.

Research output: Chapter in Book/Report/Conference proceedingChapter

Bermas, BL 2014, The medical management of the rheumatology patient during pregnancy. in Contraception and Pregnancy in Patients with Rheumatic Disease. Springer New York, pp. 273-287. https://doi.org/10.1007/978-1-4939-0673-4_14
Bermas BL. The medical management of the rheumatology patient during pregnancy. In Contraception and Pregnancy in Patients with Rheumatic Disease. Springer New York. 2014. p. 273-287 https://doi.org/10.1007/978-1-4939-0673-4_14
Bermas, Bonnie L. / The medical management of the rheumatology patient during pregnancy. Contraception and Pregnancy in Patients with Rheumatic Disease. Springer New York, 2014. pp. 273-287
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