title: Enhancing the care of women with rheumatic diseases during pregnancy: challenges and unmet needs in the Middle East.
abstract: Pregnancy in women with rheumatic disorders is known to be associated with risks for both the mother and fetus; however, these risks can be minimized with proper planning and careful management of the disease. In the Middle East, there are specific cultural challenges that may have a negative impact on the care that women with rheumatic disorders receive. There is a need for cross-collaboration between specialist physicians, improved awareness of rheumatic disorders among the general public and more open discussion with patients about the potential complications of pregnancy. Women in the region are often unwilling to discuss their disease with their partner and are even less likely to seek advice regarding family planning from their physician. The objective of this review is to highlight the specific challenges of pregnancy management and to discuss why establishing specialist pregnancy clinics for women with rheumatic disorders could be an effective solution. Such clinics can provide high quality care before, during and after pregnancy as shown in several European and US centers. Additionally, such clinics could be useful for the collection of pregnancy outcomes data from the Middle East, which may currently be lacking in the region, in order to highlight where further improvements can be made. With specialist care and analysis of pregnancy outcomes, the standard of care for women with rheumatic disorders in this area could be significantly improved.
authors: Medicine Department Rheumatology Section, Hamad Medical Corporation, PO Box 3050, Doha, Qatar. salemadi@hamad.qa.
authors: S
authors: S
authors: Al-Emadi
authors: Department of Rheumatology, Al Jahra Hospital, Al Jahra, Kuwait.
authors: F
authors: F
authors: Abutiban
authors: Faculty of Medicine, Cairo University, Cairo, Egypt.
authors: B
authors: B
authors: El Zorkany
authors: Department of Rheumatology, Hôtel-Dieu de France and School of Medicine, Saint-Joseph University, Beirut, Lebanon.
authors: N
authors: N
authors: Ziade
authors: Department of Rheumatology, Al-Amiri Hospital, Kuwait City, Kuwait.
authors: A
authors: A
authors: Al-Herz
authors: Department of Rheumatology and Immunology, Mafraq Hospital, Abu Dhabi, United Arab Emirates.
authors: M
authors: M
authors: Al-Maini
authors: Mediclinic City Hospital, Dubai Healthcare City, Dubai, United Arab Emirates.
authors: B
authors: B
authors: Khan
authors: Department of Rheumatology, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait.
authors: A
authors: A
authors: Ghanem
authors: Department of Rheumatology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
authors: H
authors: H
authors: Al Rayes
authors: Rheumatology Department, Dubai Hospital, Dubai, United Arab Emirates.
authors: J
authors: J
authors: Al Saleh
authors: King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia.
authors: H
authors: H
authors: Al-Osaimi
authors: Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
authors: M
authors: M
authors: Østensen
mesh_terms: D003376:Counseling; D019468:Disease Management; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D033183:Interdisciplinary Communication; D008877:Middle East; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D012216:Rheumatic Diseases / Q000628:therapy*; D016387:Women's Health
keywords: Autoimmune rheumatic diseases; Counselling; Interdisciplinary management; Pregnancy; Systemic lupus; Women’s health