Chronic rheumatic disease may interfere with procreation in women of childbearing age. Female patients should have counseling in regard to family planning and parenting. Preconception counseling requires risk assessment of possible maternal or fetal risks, screening for biomarkers with predictive value for adverse pregnancy outcomes, adjustment of therapy, and a schedule for monitoring and follow-up during pregnancy. Delivering comprehensive information and addressing all patient concerns are both essential for enabling patients to engage actively in decision making.
Key points
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Address family planning in all patients of fertile age. Physicians should actively offer information on reproduction issues to all patients, even those who do not specifically ask.
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Ideal conditions for pregnancy are: conception at a stage of remission or minimal disease activity while on stable, pregnancy-compatible medication.
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Address medication concerns and the benefits of optimal disease control in pregnancy with all patients.
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Points discussed during preconception counseling should be shared with all doctors and health professionals involved in the care of a pregnant patient.
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