Chronic diseases and pregnancy
Table of contents
Extract
- Chronic diseases, when untreated, impair fertility; adequate management effectively restores fertility.
- Already before conception, the treating physician should confirm the control of the disease, and an obstetrician the health of the reproductive system. In that process, also individual risks of pregnancy and changes of success are assessed.
- The pregnancy must be monitored closely throughout gestation according to the principles of monitoring high-risk pregnancy and in good collaboration between the prenatal clinic and maternity hospital Antenatal clinics and specialist care: consultations, referrals, treatment guidelines1.
- The increasing average age of parturients increases the prevalence of chronic diseases among pregnant women.
- See also Use of medication during pregnancy2.
Linked evidence summaries
- Oral beta-blockers appear to decrease the risk of severe hypertension in pregnancy. However, use of beta-blockers for mild to moderate chronic or pregnancy induced hypertension appear to increase the risk of small for gestational age infants . For severe ´late-onset´ pregnancy hypertension, intravenous labetalol may be safer than intravenous hydralazine or diazoxide.B
- Calcium channel blockers, labetalol, nifedipine, and hydralazine appear to be similarly effective for very high hypertension in pregnancy.B
- Antihypertensive drug therapy for mild to moderate hypertension during pregnancy reduces the risk of severe hypertension and pre-eclampsia. Antihypertensive drug therapy may reduce preterm birth without increase in the risk of small-for-gestational-age birth weight.A
- Metformin alone or with supplemental insulin appears to decrease macrosomia and large for gestational age babies, and neonatal hypoglycaemia in women with gestational diabetes. Metformin appears to be safe in short-term .B
- Maternal obesity is associated with foetal macrosomia, stillbirth, and low Apgar score, and appears to be associated with need of intensive care and shoulder dystocia.A
- Maternal obesity is significantly associated with an increased cesarean delivery rate, pre-eclampsia and gestational diabetes .A
- Antibiotic treatment appears to reduce the risk of pyelonephritis in pregnancy and appears to reduce the incidence of preterm delivery and low birthweight babies compared to placebo or no treatment.B
Search terms
Angiotensin-Converting Enzyme Inhibitors, Anti-Asthmatic Agents, Anticonvulsants, Antirheumatic Agents, Antithrombin III Deficiency, Arthritis, Rheumatoid, Asthma, Breast Neoplasms, Cardiology, Cardiomyopathies, Cardiovascular Abnormalities, Cardiovascular Diseases, Cerebrovascular Disorders, Chronic Disease, Creatinine, D68.8, Diabetes Mellitus, Diabetes, Gestational, Drug Therapy, Eisenmenger Complex, Embolism, Endocrinology, Epilepsy, Glomerulonephritis, Membranous, Gynaecology, Heart Diseases, Hypertension, Hypertension, Pulmonary, Hyperthyroidism, Hypothyroidism, Internal medicine, Kidney Diseases, Kidney Failure, Kidney Transplantation, Lithium, Lupus Erythematosus, Systemic, Lupus Nephritis, Marfan Syndrome, Maternal Health Services, Maternal-Child Health Centers, Mental Disorders, Metabolic Diseases, Migraine Disorders, NYHA class III, NYHA class IV, Neoplastic diseases, Nephrology, Nervous System Diseases, Neurology, Obesity, Obstetrics, Polyarteritis Nodosa, Prednisone, Pregnancy, Pregnancy, High-Risk, Protein C Deficiency, Protein S Deficiency, Proteinuria, Psychiatry, Psychotropic Drugs, Pulmonary Embolism, Pyelonephritis, Renal Insufficiency, Rheumatology, Scleroderma, Systemic, Thrombosis, Valproic Acid, Venous Thrombosis, Z32.1, Z35.9, asymptomatic bacteriuria, bacteriuria in pregnancy, benzodiazepines, cardiac axis, diastolic blood pressure, insulin treatment, intracranial aneurysm, migraine drug, migraine in pregnancy, prophylactic medication for urinary tract infections, prophylaxis of thrombosis, prostaglandin antagonists, puerperal psychosis, pyelonephritis in pregnancy, rheumatic diseases, thyroid cancer, vascular disease