Schwangerschaft bei Lupus erythematodes – ein Update

Fischer‐Betz, Rebecca; Haase, Isabell

doi:10.1007/s00393-020-00772-9

Cited by 3 publications

(22 citation statements)

References 36 publications

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“…For this paper, the recommendations of relevant medical associations, specialist conferences and institutions on rheumatic disease in persons of child-bearing age with a special focus on lupus erythematosus and antiphospholipid syndrome were reviewed in March 2023 and evaluated to see whether they still reflected current knowledge. The literature included recommendations and statements by the following organizations, institutions and authors: the European League Against Rheumatism (EULAR) 2 , 3 , 4 , the American College of Rheumatology Guideline (ACR) 5 , the 16th International Congress on Antiphospholipid-Antibodies Task Force Report 6 , the British Society for Rheumatology 7 , and the German Society for Rheumatology 8 .…”

Section: Methodsmentioning

confidence: 99%

“…Predictors for a poor outcome included higher clinical SLE activity at conception, lupus anticoagulant positivity, non-white ethnicity, taking antihypertensives, and thrombocytopenia. An early history of lupus nephritis (LN) and low C4 complement levels in early pregnancy were independently associated with a risk of renal flare 8 , 12 . A first manifestation of lupus nephritis was rare and occurred in just 2% 12 .…”

Section: Pregnancy and Lupus Erythematosusmentioning

confidence: 99%

“…A Brazilian study of women with proliferative class III/IV lupus nephritis reported more SLE flare-ups and activity during pregnancy and even after the birth, which resulted in significantly more hospitalizations and higher rates of preeclampsia 8 , 13 .…”

Section: Pregnancy and Lupus Erythematosusmentioning

confidence: 99%

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Management of Rheumatic Diseases During Pregnancy and Breastfeeding

Kuschel,

Schäfer-Graf,

Schmidt

et al. 2024

Geburtshilfe Frauenheilkd

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Purpose These recommendations issued by the AGG (Section Maternal Diseases in Pregnancy) were developed as a rapid orientation on maternal rheumatic diseases for counselling and disease management in pregnancy and breastfeeding. Methods The standard literature, consensus and position papers, guidelines and recommendations by other specialist associations were evaluated by a task force of the Section and summarized in these recommendations following a joint consensus process. Recommendations This paper provides an orientating overview of the physiology, pathophysiology and definitions of rheumatic diseases which is relevant for gynecologists and obstetricians. The recommendations focus on the maternal, fetal and neonatal diagnostic workup in cases with underlying maternal rheumatic disease.

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Section: Methodsmentioning

confidence: 99%

Section: Pregnancy and Lupus Erythematosusmentioning

confidence: 99%

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Management of Rheumatic Diseases During Pregnancy and Breastfeeding

Kuschel,

Schäfer-Graf,

Schmidt

et al. 2024

Geburtshilfe Frauenheilkd

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“…Alternativmöglichkeiten sind in Tab. 3 aufgeführt, sollten aber aufgrund einer notwendigen individualisierten SLE-Therapie nur in enger Rücksprache mit den betreuenden Nephrologen, Dermatologen oder Rheumatologen eingesetzt werden 75 , 76 .…”

Section: Spezifische Ursachen Des Pr-akiunclassified

“…Hydroxychloroquine is currently the best alternative to maintain remission of SLE and lupus nephritis because of its side-effects profile, lack of risks for fetal malformations or fetal or neonatal toxicity, the improvement in renal long-term outcomes and the up to 50% reduction in congenital heart block in infants born to anti-Ro-positive mothers, H 71 – 74 . Alternative options are listed in Table 3 , but because individualized SLE therapy is essential, these alternatives should only be used after consultation with the treating nephrologist, dermatologist or rheumatologist 75 , 76 .…”

Section: Specific Causes Of Pr-akimentioning

confidence: 99%

Pr-AKI: Acute Kidney Injury in Pregnancy – Etiology, Diagnostic Workup, Management

Scurt

Morgenroth

Bose

et al. 2022

Geburtshilfe Frauenheilkd

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Despite significant improvements in inpatient and outpatient management, pregnancy-related acute kidney injury (Pr-AKI) remains an important risk factor for early and late maternal and fetal morbidity and mortality. There is a discrepancy between the incidence of Pr-AKI in developing and in developed countries, with the former experiencing a decrease and the latter an increase in Pr-AKI in recent decades. Whereas septic and hemorrhagic complications predominated in the past, nowadays hypertensive disorders and thrombotic microangiopathy are the leading causes of Pr-AKI. Modern lifestyles and the availability and widespread use of in-vitro fertilization techniques in industrialized countries have allowed more women of advanced age to become pregnant. This has led to a rise in the percentage of high-risk pregnancies due to the disorders and comorbidities inherent to or accompanying aging, such as diabetes, arterial hypertension and preexisting chronic kidney disease. Last but not least, the heterogeneity of symptoms, the often overlapping clinical and laboratory characteristics and the pathophysiological changes related to pregnancy make the diagnosis and management of Pr-AKI a difficult and challenging task for the treating physician. In addition to general supportive management strategies such as volume substitution, blood pressure control, prevention of seizures or immediate delivery, each disease entity requires a specific therapy to reduce maternal and fetal complications. In this review, we used the current literature to provide a summary of the physiologic and pathophysiologic changes in renal physiology which occur during pregnancy. In the second part, we present common and rare disorders which lead to Pr-AKI and provide an overview of the available treatment options.

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Lupusnephritis

Mücke

Schneider

2022

Z Rheumatol

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Schwangerschaft bei Lupus erythematodes – ein Update

Cited by 3 publications

References 36 publications

Management of Rheumatic Diseases During Pregnancy and Breastfeeding

Management of Rheumatic Diseases During Pregnancy and Breastfeeding

Pr-AKI: Acute Kidney Injury in Pregnancy – Etiology, Diagnostic Workup, Management

Lupusnephritis

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