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Schwangerschaft bei entzündlich rheumatischen Erkrankungen

Pregnancy and inflammatory rheumatic diseases

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Zusammenfassung

Kinderwunsch und Schwangerschaften bei entzündlich rheumatischen Erkrankungen stellen eine besondere Herausforderung in der Arzt-Patienten-Beziehung dar und erfordern eine optimale gemeinsame Strategie. Die meisten betroffenen Frauen können eine erfolgreiche Schwangerschaft erleben, und die überwiegende Zahl der Kinder kommt gesund zur Welt. Die Planung einer Schwangerschaft in einer möglichst inaktiven Erkrankungsphase und eine regelmäßige Überwachung sind von entscheidender Bedeutung. Dabei sind die sorgfältige Einschätzung von möglichen Risiken und die Aufklärung über den Einsatz von antirheumatischen Therapien vor, während und nach einer Gravidität ein wichtiger Bestandteil.

Abstract

Pregnancy in women with rheumatic diseases represents a challenge for patients and physicians and requires optimal shared decision-making strategies. However, the majority of women can have a successful pregnancy and the vast majority of babies are born healthy. Specific preconception care should be offered to women with rheumatic diseases to optimize and increase the chances of a successful pregnancy. A careful assessment of possible risks and the justified use of antirheumatic drugs before, during and after pregnancy are key issues.

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Abbreviations

aCl:

Anticardiolipinantikörper

aPl:

Antiphospholipidantikörper

APS:

Antiphospholipidsyndrom

AS:

ankylosierende Spondylitis

β2Glyc-AK:

Anti-Beta2-Glycloprotein-AK

DAS:

Disease Activity Score

FCV:

forcierte Vitalkapazität

IVIG:

intravenöse Immunglobuline

LA:

Lupus-Antikoagulans

LMWH:

„low molecular weight heparin“

MMF:

Mycophenolsäure

NLS:

neonatales Lupus-Syndrom

PAP:

„pulmonary artery pressure“

RA:

rheumatoide Arthritis

RF:

Rheumafaktor

SLE:

Lupus erythematodes

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Einhaltung ethischer Richtlinien

Interessenkonflikt. R. Fischer-Betz und S. Späthling-Mestekemper geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Poliklinik für Rheumatologie, Heinrich Heine Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland

    R. Fischer-Betz

  2. Rheumatologische Schwerpunktpraxis, München, Deutschland

    S. Späthling-Mestekemper

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Correspondence to R. Fischer-Betz.

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Fischer-Betz, R., Späthling-Mestekemper, S. Schwangerschaft bei entzündlich rheumatischen Erkrankungen. Z. Rheumatol. 72, 669–682 (2013). https://doi.org/10.1007/s00393-013-1223-9

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  • DOI: https://doi.org/10.1007/s00393-013-1223-9

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