MANAGEMENT OF WOMEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS IN THE PERIOD BEFORE PLANNING A PREGNANCY, DURING PREGNANCY PLANNING, POSTPARTUM AND MENOPAUSE
Yehudina Ye.D.1, Sapozhnychenko L.V.2, Pampukha O.O.2
Summary. Background. The management of reproductive health issues in patients with systemic lupus erythematosus (SLE) differs from that in healthy persons. Aim. Review literature illustrating current data about features of management of women with SLE in the period before pregnancy planning, during pregnancy planning, postpartum period and during menopause. Methods. This work presents review of literature about features of contraception, cervical cancer screening, pre-conception, postpartum period and menopause for women with SLE, based on a search of English-language articles in the PubMed database for the last 20 years, by keywords — SLE, contraception, pre-pregnancy training, pregnancy, lactation, drugs. Results. Patients with SLE in stable or low disease activity should use highly effective contraceptives depending on the presence of antiphospholipid antibodies. During pre-pregnancy preparation for SLE patients, it is important to identify common risk factors for pregnancy complications and risk factors associated with SLE, adjust SLE treatment, and continue treatment during pregnancy and lactation. Patients with SLE during menopause are more prone to osteoporosis and therefore should receive some therapy. Hormone replacement therapy is not contraindicated in most women with SLE. Conclusions. With adequate planning, treatment, and monitoring, most women with SLE can avoid complications related to reproductive health.
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