Contraception and Pre-conception Counseling in Women with Autoimmune Disease

Publication date: Available online 8 October 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Lisa R. SammaritanoAbstractAppropriate contraception and preconception counseling are critical for women of reproductive age with systemic autoimmune diseases since clinical diagnosis, rheumatology medications, and disease activity may impact the safety or efficacy of certain contraceptives as well as the risk of adverse pregnancy outcomes. The presence of antiphospholipid antibodies (anticardiolipin, anti-β2 Glycoprotein I and lupus anticoagulant) is the most important determinant of contraception choice, since women with these antibodies should not receive estrogen-containing contraceptives due to the increased risk of thrombosis. Counseling pre-pregnancy generally includes assessment of preexisting disease-related organ damage, current disease activity, antiphospholipid antibodies, anti-Ro/SS-A and anti-La/SS-B antibodies, and medication safety in pregnancy. Quiescent autoimmune disease for six months on pregnancy compatible medications optimizes maternal and fetal/neonatal outcomes for most patients.
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - Category: OBGYN Source Type: research