Rheumatologists and OB-GYNs must communicate openly with each other and to patients with rheumatic diseases who are considering pregnancy.
When considering pregnancy, patients with rheumatic conditions must consult with their healthcare providers. Additionally, there must be an open line of communication between their rheumatologist and obstetrician-gynecologist (OB-GYN).
“Rheumatology patients have special concerns and risk with regard to pregnancy, and therefore it is very, very important that this be planned,” said Lisa Sammaritano, MD, of Weill Cornell Medicine and Hospital for Special Surgery in an interview with HCPLive®.
Systemic lupus and antiphospholipid antibodies syndrome historically have posed the greatest risk for both the mother’s health and the outcome of the pregnancy. Both disorders may coincide, thus increasing risk. In fact, about 1/3 of patients with lupus also present with antiphospholipid antibodies.
Sammaritano urged rheumatologists to inquire into their patients’ intentions, and to caution against inadvertent pregnancies. Furthermore, the ideal treatment and management scenario would be a level of synergy between both the rheumatologist and OB-GYN; both specialists must be attuned to patient conditions and pregnancy plans.
“We may think of this as the domain of the OB-GYN. Of course, they know everything about pregnancy and contraception. But we know everything about lupus and other related diseases,” she said. “And really, it takes both of those knowledge bases to come up with the right solution for any given patient.”