The Detergents And Disinfectants For Instruments And Surfaces (Hexanios - Surfanios)

PREGNANCY AND CONNECTIVE TISSUE DISEASES

systemic lupus erythematosus (SLE)

• SLE improves in 1:3 pregnancies, remains unchanged in 1:3 and worsens in 1:3 pregnancies. Pregnancy outcomes depend primarily on the severity of the underlying renal disease.

Fetal heart block and fetal bradycardia may occur due to the myocardium and conduction system being affected by antibodies.

• Preeclampsia risk is high in patients with lupus nephritis and preeclampsia develops more frequently in patients with positive antiphospholipid antibodies.

• Perinatal complication risks are significantly increased in pregnant women with lupus. Among them; preterm labor, IUGR, stillbirth, and neonatal lupus syndrome.

Due to the myocardium and conduction system being affected by antibodies

(especially anti SS-A and anti SS-B) fetal heart block and fetal bradycardia may occur.

Differential Diagnosis of Active Lupus and Preeclampsia Syndrome
	Lupus	preeclampsia
Clinical findings	Fatigue, headache. extrarenal findings (rash, serositis, arthritis)	Headache, confusion, visual symptoms, convulsion
Blood pressure	normal or high	High
Anemia	hemolytic anemia	no
proteinuria	There is	There is
creatinine	normal or high	normal or high
Transaminases	Normal	normal or high
complement	decreased	Normal

Rheumatoid Arthritis

• Pregnancy is protective against rheumatoid arthritis and improves the clinical picture.

However, the risk of relapse increases 6 times in the first 3 months after birth. Rheumatoid arthritis does not have a negative effect on pregnancy outcomes.

Systemic Sclerosis (Scleroderma)

• Disease is usually stable during pregnancy if basal functions are good

however, exacerbations occur in 1/3 of the cases.

• Maternal and fetal outcomes depend on the severity of the underlying disease. The risk of superimposed preeclampsia is increased in patients with renal failure and malignant hypertension. There is an increased risk of preterm birth, very low birth weight infants, IUGR and perinatal mortality.

PREGNANCY AND SKIN DISEASES

pregnancy specific dermatoses
	Frequency	Characteristic lesion	Adverse effects on pregnancy	Treatment
Pregnancy Cholestasis	Widespread	No primary skin lesion, Secondary excoriation due to scratching	Perinatal morbidity increases	Antipruritic, Cholestyramine, Ursodeoxycholic acid
Itchy urticarial papules and plaques of pregnancy	Widespread	Erythematous pruritic papule or plaque Patchy or generalized involvement Occurs on abdomen, thighs, buttocks and especially striae. But the belly is preserved	no	Antipruritic, Emollient topical steroid, Oral steroid
Atopic eruptions of pregnancy: Pregnancy eczema	Widespread	Dry, red scaly patches, Flexor surfaces of extremities, neck and face	no	Antipruritic, Emollient topical steroid, Oral steroid
pregnancy prurigo	Widespread	1-5 mm, pruritic red papules, Extensor surfaces of extremities, trunk	*	*
itchy folliculitis of pregnancy	Rare	Small, red papule, sterile pustule on trunk	*	*
Pemphigoid gestationalis	Rare	Erythematous pruritic papule. plaques, vesicles and bullae, Abdomen (often including umbilicus), extremities	Preterm birth, IUGG, Transient neonatal lesion	Antipruritic, Emollients topical steroid, Oral steroid

Course of Systemic Diseases in Pregnancy
Diseases worsened by pregnancy	Diseases cured by pregnancy	Diseases not affected by pregnancy
hepatitis E	rheumatoid arthritis	ulcerative colitis
Depression	peptic ulcer	Crohn's disease
aplastic anemia	multiple sclerosis	ITP
sickle cell anemia	Hashimoto	myasthenia gravis
Autoimmune Hemolytic Anemia	Fox-Fordyce Disease	Hereditary spherocytosis
Paroxysmal Nocturnal Hemoglobinuria	Hidradenitis suppurativa	sarcoidosis
Reflux esophagitis
Epilepsy (increases 20-30%)

Diseases with 1/3 rule in pregnancy; Asthma and SLE

PREGNANCY AND MALIGN DISEASES

• Breast, cervix, hematological malignancies and melanoma are among the most common cancers in pregnancy.

The most common cancer in pregnancy is stated differently in different sources (breast, cervix or lymphoma).

The most common surgical procedure during pregnancy is laparoscopy. During laparoscopy, hypercarbia and acidosis occur and uteroplacental perfusion decreases. The cerebrospinal fluid pressure increases.