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Vol. 6. Issue 1.
Pages 43-48 (January - February 2010)
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Vol. 6. Issue 1.
Pages 43-48 (January - February 2010)
DOI: 10.1016/S2173-5743(10)70008-3
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Drugs employed during pregnancy and contraceptive methods in rheumatic disease. New evidence
Fármacos durante el embarazo y métodos contraceptivos en enfermedades reumáticas. Nuevas aportaciones
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Xavier Juanola Roura
Corresponding author
, Valeria Ríos Rodríguez, Diana de la Fuente de Dios
Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
Article information
Abstract

Voluntary birth control, the ability to identify the best moment for becoming pregnant depending on disease activity, and the need to avoid conception during the administration of teratogenic drugs are the main reasons for the use of contraceptive methods among women with rheumatic diseases.

This article reviews the risks that antirheumatic drugs represent during conception, pregnancy and lactation and the contraceptive methods that are currently available to patients. Hormonal therapy has developed considerably and can further our understanding of safety aspects, especially for systemic lupus erythematosus patients. Recently the methods of administration have evolved, and now include transdermal and intravaginal routes, a progesterone-releasing intrauterine device, and an extended-cycle oral contraceptive.

Rheumatologists work increasingly in conjunction with patients to assist in choices regarding contraceptive methods and pregnancy planning. Each decision should be individualized according to the personal preference and the stage of reproductive life.

Keywords:
Drugs
Pregnancy
Lupus
Contraception
Resumen

El control voluntario de la natalidad, el hecho de poder establecer el mejor momento de la gestación en función de la actividad de la enfermedad y la necesidad de evitar el embarazo debido a la indicación de fármacos potencialmente teratógenos constituyen las razones principales para la utilización de métodos contraceptivos en pacientes afectas de enfermedades reumáticas.

En este artículo se revisan los posibles riesgos durante el embarazo de las medicaciones utilizadas en reumatología y los diversos métodos contraceptivos disponibles actualmente. En los últimos años se ha producido un mejor conocimiento de la seguridad de los métodos contraceptivos hormonales con datos especialmente relevantes de su utilización en pacientes con lupus eritematoso sistémico. La evolución de la contracepción hormonal con nuevas vías de administración, como la transdérmica, la intravaginal y los dispositivos intrauterinos o los implantes liberadores de progestágenos, han significado avances evidentes en este campo.

La implicación del reumatólogo, como responsable de la atención de estos pacientes, es requerida con mayor frecuencia y el conocimiento de todos los métodos disponibles, con todas sus ventajas, desventajas y efectos adversos ayudará a facilitar información para que la pareja pueda escoger en cada caso la mejor opción.

Palabras clave:
Fármacos
Embarazo
Lupus
Contracepción
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