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• W50630107 endingPage "621" @default.
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• W50630107 abstract "Pregnancy is a state in which normal human physiology is dramatically altered. Virtually every organ system is affected, resulting in changes in many physiologic parameters. In the case of women with chronic medical illness, pregnancy may exacerbate or reactivate a disease state. In addition, the routine assessments that are performed during prenatal care may result in the diagnosis of subclinical or early disease in apparently healthy women. Many maternal diseases and the therapies used to treat them have the potential to affect fetal growth and development adversely.Over the past two generations, substantial improvements in maternal and infant mortality rates have occurred in the United States. A large portion of these gains can be attributed to technologic advances in the field of neonatology as well as to public health initiatives that have expanded access to and quality of care for high-risk populations. Much of the progress in decreasing maternal morbidity106 and mortality in recent decades is directly attributable to improvements in the diagnosis and treatment of medical disorders that complicate pregnancy. To sustain the gains made in maternal and infant health and to make further progress in this area of clinical medicine, it is essential that medical providers caring for women of reproductive age understand the preconceptual needs of women with chronic illnesses. In addition, they should be familiar with the physiologic changes of pregnancy and how these changes affect established medical conditions. Practitioners should be able either to manage or to assess and refer appropriately the medically complicated pregnant woman. Appropriate risk assessment and referral are particularly important because demographic data indicate that increasing numbers of American women are delaying childbearing.5 In light of this, it is significant that some data suggest that increased numbers of medical complications occur in older pregnant women.14 In some populations, maternal mortality has also been found to be substantially increased in women who give birth after age 40.108This article is not intended to be a comprehensive review of medical diseases in pregnancy. Rather, after a brief review of normal physiologic changes in pregnancy, the focus is on topics in obstetric medicine in which there have been significant advances in knowledge of pathophysiology and in management strategies, as in the case of the antiphospholipid antibody (APA) syndrome. An update on thromboembolic disease in pregnancy is included because this entity remains a leading cause of maternal morbidity and mortality. In addition, reviews of common medical diseases that are rising in incidence in the general population and specifically in women of reproductive age, such as human immunodeficiency virus (HIV) infection, asthma, and tuberculosis, are included. Given the fact that increased numbers of older women are becoming pregnant, updates on cardiopulmonary topics, such as ischemic heart disease, pulmonary edema, and cardiac arrhythmias, are included. A section on diabetes mellitus and carbohydrate intolerance during pregnancy is also provided because these entities are likely to rise in incidence as the trend toward delayed childbearing continues." @default.
• W50630107 created "2016-06-24" @default.
• W50630107 creator A5085498326 @default.
• W50630107 date "1989-05-01" @default.
• W50630107 modified "2023-10-17" @default.
• W50630107 title "Autoimmune Disease in Pregnancy" @default.
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• W50630107 doi "https://doi.org/10.1016/s0025-7125(16)30660-5" @default.
• W50630107 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/2649759" @default.
• W50630107 hasPublicationYear "1989" @default.
• W50630107 type Work @default.
• W50630107 sameAs 50630107 @default.

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