[Biological monitoring of autoimmune diseases during pregnancy].
This review focuses on auto-immune diseases which frequently affect women and can have interactions with pregnancy: lupus erythematosus (LES), antiphospholipide syndrome (SAPL), Sjögren's syndrome (GS), rheumatoid arthritis (PR) and auto-immune thyroiditis. LES may flare at the end of a pregnancy and during post-partum. Its biological monitoring during pregnancy is well established. SAPL is at risk of sterility, prematurity, Hellp syndrome, eclampsia and retroplacental hematoma. The main risk, actually risk is foetal loss by placental ischemia, which has to be well known as 2 randomised studies have proven the efficacy of treatments with aspirin +/- subcutaneous heparin. LES, GS and PR can both be associated with anti SS-A +/- anti SS-B antibodies linked to a risk of congenital auriculo-ventricular block, which is fortunately low (less than 5% of the cases). Auto-immune thyroiditis are often revealed during pregnancy and may be enhanced during the six first months of post-partum.
Blétry
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Service de médecine interne, hôpital Foch, 40, rue Worth BP 36, 92151 cedex, Suresnes, France. o.bletry@hopital-foch.org <o.bletry@hopital-foch.org>
Molina
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Somogyi
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D000328:Adult; D016736:Antiphospholipid Syndrome / Q000150:complications; D001172:Arthritis, Rheumatoid / Q000150:complications; D001327:Autoimmune Diseases / Q000150:complications*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D011379:Prognosis; D012307:Risk Factors; D012859:Sjogren's Syndrome / Q000150:complications; D013967:Thyroiditis, Autoimmune / Q000150:complications
Surveillance biologique des pathologies auto-immunes pendant la grossesse.