Author/Editor		Praprotnik, Sonja; Tomšič, Matija
Title		Zdravljenje bolnic z revmatično boleznijo v nosečnosti
Translated title		Treatment strategy of the rheumatic disease during pregnancy
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 42, št. Suppl 3
Publication year		2003
Volume		str. 103-8
Language		slo
Abstract		Treatment strategy of the rheumatic disease during pregnancy will vary according to the maternal or fetal compromise expected. Nonsteroidal anti-inflammatory drug treatment of severe inflammatory rheumatic symptoms during pregnancy is appropriate, but such treatment should be withdrawn 6-8 weeks before delivery, because of the effects of these agents on the patent ductus aerteriosus and the risk of maternal and/or fetal hemorrhage. Some corticosteroids such as prednisone and prednisolone do not readily cross the placenta and ean be safely used during pregnancy. There is limited information on the safety of disease-modifying antirheumatic drugs during pregnancy. Sulfasalasine and hydroxychloroquine treatment may be mantained while gold therapy should probably be discontinued. Use of cyclosporin may be an alternative to other therapy in pregnant patients with severe rheumatic disease. Azathioprine can be used when the maternal condition requires a cytotoxic drug during the fist trimester. Cyclophosphamide, leflunomide and metotrexate are contraindicated during pregnancy. Cyclophosphamide may be considered in late pregnancy if the mother has a life-threatening condition.
Summary		O strategiji zdravljenja nosečih revmatoloških bolnic se odločimo glede na ogroženost matere in ploda. Nesteroidna protivnetna zdravila lahko v nosečnosti uporabljamo za lajšanje revmatičnih težav Zaradi njihovega vpliva na zaprtje arterioznega voda in na možne krvavitve med porodom pri materi in otroku ta zdravila praviloma ukinemo 6-8 tednov pred porodom. Nefluorirane glukokortikoide, kot sta npr. prednizon in prednizolon, lahko varno uporabljamo med nosečnostjo. Podatki o uporabi temeljnih zdravil pri revmatoidnem artritisu so pičli. Vsekakor je uporaba sulfasalazina in hidroksiklorokina dokaj varna. Zdravljenje z zlatom med nosečnostjo ni priporočljivo. Bolj ogroženim revmatološkim bolnicam, ki med nosečnostjo potrebujejo intenzivnejše imunosupresivna zdravljenje, lahko predpišemo ciklosporin in azatioprin. Ciklofosfamid, leflunomid in metotreksat so med nosečnostjo kontraindicirani, razen ciklofosfamida v pozni nosečnosti; če je ogroženo materino življenje.
Descriptors		RHEUMATIC DISEASES ANTI-INFLAMMATORY AGENTS, NON-STEROIDAL GLUCOCORTICOIDS, SYNTHETIC ANTIMALARIALS PREGNANCY