Artritis Reumatoide y embarazo. Actualización

  • Elías Rojas Universidad Nacional de Asunción, Facultad de Ciencias Médicos, Departamento de Reumatología. San Lorenzo, Paraguay
  • Sonia Cabrera Villalba Universidad Nacional de Asunción, Facultad de Ciencias Médicos, Departamento de Reumatología. San Lorenzo, Paraguay
Palabras clave: Artritis Reumatoide, embarazo

Resumen

La Artritis Reumatoide (AR) es una afección autoinmune inflamatoria crónica frecuente, que se caracteriza por la inflamación persistente de las articulaciones sinoviales. Encarar el tratamiento de la AR en el embarazo resulta complejo atendiendo a la necesidad de una interacción correcta entre el monitoreo de la actividad de la enfermedad y la mitigación de los síntomas con terapias no tóxicas pero eficaces.

Durante el embarazo se puede observar una disminución de la actividad de la enfermedad, entre el 48 % al 86 %. Algunas pacientes con AR podrían desarrollar mayor actividad de la enfermedad, así como partos prematuros, bajo peso del niño al nacer e incluso abortos. Los AINEs podrían elevar el riesgo de subfertilidad en las pacientes con AR.

La Hidroxicloroquina, así como la Sulfasalazina, se pueden administrar de manera segura durante todo el embarazo. Los glucocorticoides a dosis mayores a 7,5 se asociaron con parto prematuro. Durante el 1er trimestre del embarazo el uso de anti-TNF de manera continua está recomendada. Tanto la Leflunomida como el Metotrexate se deben suspende cuando se desea un embarazo.

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Publicado
2020-06-24
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1.
Rojas E, Cabrera Villalba S. Artritis Reumatoide y embarazo. Actualización . Rev. parag. reumatol. [Internet]. 24 de junio de 2020 [citado 28 de septiembre de 2020];6(1):36-7. Disponible en: http://revista.spr.org.py/index.php/spr/article/view/119
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