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RHEUMATIC DISORDERS DURING PREGNANCY

1. Juvenile Rheumatoid Arthitis
  • a disease of connective tissue (synovial membrane destruction) with joint inflammation and contractures.
  • symptoms improved during pregnancy because of increased circulating corticosteroids in the maternal bloodstream which recur during postpartum.
  • with corticosteroid and salicylate therapy, prolonged pregnancy results. Salicylate interferes prostaglandin synthesis that it inhibits labor process.
  • due to salicylates, infant can have bleeding defects and premature closure of ductus arteriosus. Also, women should not breastfeed.
  • salicylate dose must be decreased 2 weeks before term.
2. Systemic Lupus Erythematosus
  • is a multi system chronic degenerative disease of connective tissues. Symptoms are controlled during pregnancy and exacerbates after delivery.
  • most marked characteristic is the erythematous "butterfly-shaped" rash on the face.
  • most serious kidney change is the fibrin deposite that blocks glomeruli leading to necrosis and scarring, expect renal failure. thickening collagen tissues in the vascular system pose life threatening situation.
  • clients with SLE has antiphospholipid antibodies which increases tendency for thrombi formation.
  • SLE is associated to infants small for gestational age, abortion,premature birth and anemia.