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Chapter 26 - Autoimmune Disease

Published online by Cambridge University Press:  26 January 2024

By
Caroline S. Grange  and
Annika Smith
Edited by
David R. Gambling ,
M. Joanne Douglas  and
Grace Lim
David R. Gambling
Affiliation:
University of California, San Diego
M. Joanne Douglas
Affiliation:
University of British Columbia, Vancouver
Grace Lim
Affiliation:
University of Pittsburgh
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Summary

An autoimmune disease represents a pathological condition caused by an immune response directed against an antigen within the body of the host. The incidence and activity of autoimmune diseases are particularly high in young women and hence their occurrence in parturients is not uncommon. Autoimmune diseases often involve multiple systems and have a wide range of clinical manifestations and complications necessitating a multidisciplinary approach to management in the obstetric population, involving obstetricians, anesthesiologists, neonatologists, and rheumatologists. All affected organ systems should be evaluated and advice from appropriate medical specialties sought. The effect of autoimmune diseases and their treatment on pregnancy, and the effect of pregnancy on the disease itself varies between individual diseases. This chapter discusses the implications of the following autoimmune diseases in pregnancy: rheumatoid arthritis, systemic lupus erythematosus, polyarteritis nodosa, systemic sclerosis, antiphospholipid syndrome, and multiple sclerosis.

Keywords

rheumatoid arthritissystemic lupus erythematosuspolyarteritis nodosasystemic sclerosisantiphospholipid syndromemultiple sclerosis
Type
Chapter
Information
Obstetric Anesthesia and Uncommon Disorders , pp. 421 - 442
Publisher: Cambridge University Press
Print publication year: 2024

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References

Aletaha, D, Neogi, T, Silman, AJ, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis 2010;69:1580–1588.Google Scholar
Hunter, TM, Boytsov, NN, Zhang, X, et al. Prevalence of rheumatoid arthritis in United States adult population in healthcare claims database, 2004–2014. Rheumatol Int 2017;37:1555–1557.CrossRefGoogle Scholar
De Rycke, L, Peene, I, Hoffman, IE, et al. Rheumatoid factor and anticitrullinated protein antibodies in rheumatoid arthritis: diagnostic valve, association with radiological progression rate, and extra-articular manifestations. Ann Rheum Dis 2004;63:1587–1593.CrossRefGoogle Scholar
Smolen, JS, Landewe, RBM, Bijlsma, JWJ, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease modifying antirheumatic drugs: 2019 update. Ann Rheum Dis 2020;79:685–699.Google Scholar
Jethwa, H, Lam, S, Smith, C, et al. Does rheumatoid arthritis really improve during pregnancy? A systematic review and metaanalysis. J Rheumatol 2019;46:245–250.Google Scholar
Forger, F, Villiger, PM. Immunological adaptation in pregnancy that modulate rheumatoid arthritis. Nat Rev Rheumatol 2020;16:113–122.Google Scholar
Silman, AJ, Kay, A, Brennan, P. Timing of pregnancy in relation to the onset of rheumatoid arthritis. Arthritis Rheum 1992;35:152–155.Google Scholar
Brouwer, J, Hazes, JMW, Laven, JSE, et al. Fertility in women with rheumatoid arteritis: influence of disease activity and medication. Ann Rheum Dis 2015;74:1836–1841.Google Scholar
Kishore, S, Mittal, V, Majithia, V. Obstetric outcomes in women with rheumatoid arthritis: results from Nationwide Inpatient Sample Database 2003–2011. Semin Arthritis Rheum 2019;49:236–240.Google Scholar
Aljary, H, Czuzoj-Shulman, N, Spence, AR, et al. Pregnancy outcomes in women with rheumatoid arthritis: a retrospective population – based cohort study. J Matern Fetal Neonatal Med 2020;33:618–624.Google Scholar
Nalli, C, Galli, J, Lazzaroni, MG. Long-term outcome in children born from mothers with autoimmune diseases. Best Pract Res Clin Obstet Gynaecol 2020;64:107–116.Google Scholar
Knudsen, SS, Thomsen, AFVH, Deleuran, BW, et al. Maternal rheumatoid arthritis during pregnancy and neurodevelopmental disorders in offspring: a systematic review. Scand J Rheumatol 2021;50:253–261.Google Scholar
Guller, S, Kong, L, Wozniak, R, et al. Reduction of extracellular matrix protein expression in human amnion epithelial cells by glucocorticoids: a potential role in preterm rupture of fetal membranes. J Clin Endocrinol Metab 1995;80:2244–2250.Google Scholar
Barbhaiya, M, Bermas, B. Evaluation and management of systemic lupus erythematosus and rheumatoid arthritis during pregnancy. Clin Immunol 2013;149:225–235.Google Scholar
Ngian, G-S, Briggs, AM, Ackerman, IN, et al. Safety of anti-rheumatic drugs for rheumatoid arthritis in pregnancy and lactation. Int J Rheum Dis 2016;19:834–843.Google Scholar
Tosounidou, S, Gordon, C. Medicines in pregnancy and breastfeeding. Best Pract Res Clin Obstet Gynaecol 2020;64:68–76.Google Scholar
Prasarn, ML, Horodyski, M, Schneider, P, et al. The effect of cricoid pressure on the unstable cervical spine. J Em Med 2016;50:427–432.Google Scholar
Paimela, L, Laasonen, L, Kankaanpaa, E, et al. Progression of cervical spinal changes in patients with early rheumatoid arthritis. J Rheumatol 1997;24:1280–1284.Google Scholar
Bouchaud-Chabot, A, Liote, F. Cervical spine involvement in rheumatoid arthritis: a review. Joint Bone Spine 2002;69:141–154.Google Scholar
Karhu, JO, Parkkola, RK, Koskinen, SK. Evaluation of flexion/extension of the upper cervical spine in patients with rheumatoid arthritis: an MRI study with a dedicated positioning device compared to conventional radiographs. Acta Radiologica 2005;46:55–66.Google Scholar
Tokunaga, D, Hase, H, Mikami, Y, et al. Atlantoaxial subluxation in different intraoperative head positions in patients with rheumatoid arthritis. Anesthesiology 2006;104:675–679.Google Scholar
Lisowska, B, Rutkowska-Sak, L, Maldyk, P, et al. Anaesthesiological problems in patients with rheumatoid arthritis undergoing orthopaedic surgeries. Clin Rheumatol 2008;27:553–556.Google Scholar
Gu, J, Xu, K, Ning, J, et al. GlideScope-assisted fiberoptic bronchoscope intubation in a patient with severe rheumatoid arthritis. Acta Anaesthesiol Taiwan 2014;52;85–87.Google Scholar
Samanta, R, Shoukrey, K, Griffiths, R. Rheumatoid arthritis and anaesthesia. Anaesthesia 2011;66:1146–1159.Google Scholar
Popat, MT, Chippa, JH, Russell, R. Awake fibreoptic intubation following failed regional anaesthesia for Caesarean section in a parturient with Still’s disease. Eur J Anaesthesiol 2002;17:211–214.Google Scholar
Kobjitani, A, Miyawaki, T, Kasuya, K, et al. Anesthetic management for advanced rheumatoid arthritis patients with acquired micrognathia undergoing temporomandibular joint replacement. J Oral Maxillofac Surg 2002;60:559–566.Google Scholar
Leino, KA, Kuusniemi, KS, Palve, HK, et al. Spread of spinal block in patients with rheumatoid arthritis. Acta Anaesthesiol Scand 2010;54:65–69.CrossRefGoogle ScholarPubMed
Izmirly, PM, Parton, H, Wang, L, et al. Prevalence of systemic lupus erythematosus in the United States: estimates from a meta-analysis of the Centers for Disease Control and Prevention National Lupus Registries. Arthritis Rheumatol 2021;73:991–996.Google Scholar
Singh, RR, Yen, EY. SLE mortality remains disproportionately high, despite improvements over the last decade. Lupus 2018;27:1577–1581.Google Scholar
Aringer, M, Costenbader, K, Daikh, D, et al. 2019 European League Against Rheumatism / American College of Rheumatology classification criteria for systemic lupus erythematosus. Ann Rheum Dis 2019;78:1151–1159.CrossRefGoogle ScholarPubMed
Lateef, A, Petri, M. Managing lupus during pregnancy. Best Pract Res Clin Rheumatol 2013;27:435–447.Google Scholar
Pastore, DEA, Costa, ML, Surita, FG. Systemic lupus erythematosus and pregnancy: the challenge of improving antenatal care and outcomes. Lupus 2019;28:1417–1426.Google Scholar
Petri, M. The Hopkins Lupus Pregnancy Center: the key issues in management. Rheum Dis Clin North Am 2007;33:227–235.Google Scholar
Hickman, RA, Gordon, C. Causes and management of infertility in systemic lupus erythematosus. Rheumatology 2011;50:1551–1558.Google Scholar
Clowse, MEB, Chakravarty, E, Costenbader, KH, et al. Effects of infertility, pregnancy loss and patient concerns on family size of women with rheumatoid arthritis and systemic lupus erythematosus. Arthritis Care Res (Hoboken) 2012;64:668–674.Google Scholar
Borello, E, Lojacono, A, Gatto, M, et al. Predictors of maternal and fetal complications in SLE patients: a prospective study. Immunol Res 2014;60:170–176.CrossRefGoogle Scholar
Clowse, ME, Magder, LS, Witter, F. The impact of increased lupus activity on obstetric outcomes. Arthritis Rheum 2005;52:514–521.Google Scholar
Petri, M. Pregnancy and systemic lupus erythematosus. Best Pract Res Clin Obstet Gynaecol 2020;64:24–30.Google Scholar
Hirashima, C, Ogoyama, M, Abe, M, et al. Clinical usefulness of serum levels of soluble fms-like tyrosine kinase 1/placental growth factor ratio to rule out preeclampsia in women with new-onset lupus nephritis during pregnancy. CEN Case Reports 2019;8:95–100.Google Scholar
Saavedra, MA, Miranda-Hernandez, D, Lara-Mejia, A, et al. The use of antimalarial drugs is associated with a lower risk of pre-eclampsia in lupus pregnancy: a prospective cohort study. Int J Rheum Dis 2020;23:633–640.Google Scholar
Clowse, ME, Jamison, M, Myers, E, et al. A national study of the complications of lupus in pregnancy. Am J Obstet Gynecol 2008;199:127.e1–e6.Google Scholar
Buyon, JP, Kim, MY, Guerra, MM, et al. Predictors of pregnancy outcomes in patients with lupus: a cohort study. Ann Intern Med 2015;163:153–163.Google Scholar
Mankee, A, Petri, M, Magder, LS. Lupus anticoagulant, disease activity, and low complement in the first trimester are predictive of pregnancy loss. Lupus Sci Med 2015;2:e000095.Google Scholar
Buyon, JP, Clancy, RM, Friedman, DM. Cardiac manifestations of neonatal lupus erythematosus: guidelines to management, integrating clues from the bench and bedside. Nat Clin Practice Rheumatol 2009;5 :139–148.Google ScholarPubMed
Jeffries, M, Bruner, G, Glenn, S, at al. Sulpha allergy in lupus patients: a clinical perspective. Lupus 2008;17:202–205.Google Scholar
Sammaritano, LR, Bermas, BL, Chakravarty, EE, et al. American College of Rheumatology guideline for the management of reproductive health in rheumatic and musculoskeletal disease. Arthritis Rheumatol 2020;72:529–556.Google Scholar
Yelnik, CM, Laskin, CA, Porter, TF, et al. Lupus anticoagulant is the main predictor of adverse pregnancy outcomes in aPL-positive patients: validation of PROMISSE study results. Lupus Sci Med 2016;3:000131.Google Scholar
Eudy, AM, Siega-Riz, AM, Engel, SM, et al. Effect of pregnancy on disease flares in patients with systemic lupus erythematosus. Ann Rheum Dis 2018;77:855–860.Google Scholar
Izmirly, P, Saxena, A, Buyon, JP. Progress in the pathogenesis and treatment of cardiac manifestations of neonatal lupus. Curr Opin Rheumatol 2017;29:467–472.Google Scholar
LeFevre, ML. U.S. Preventive Services Task Force. Low-dose aspirin use for the prevention of morbidity and mortality from pre-eclampsia: U.S. Preventative Services Task Force recommendation statement. Ann Intern Med 2014;161:819–826.Google Scholar
Systemic lupus, Ben-Menachem E erythematosus: a review for anesthesiologists. Anesthesia Analgesia 2010;111:665–676.Google Scholar
Cuenco, J, Tzeng, G, Wittels, W. Anesthetic management of the parturient with systemic lupus erythematosus, pulmonary hypertension, and pulmonary edema. Anesthesiology 1999;91:568–570.CrossRefGoogle ScholarPubMed
Wu, L, Jiang, X-Q, Xiong, Y-Q, et al. Muscle weakness of the lower limbs after epidural anesthesia in a pregnant woman with undiscovered systemic lupus erythematosus. Anesth Analg 2020;135:621–622.Google Scholar
Vyas, V, Shukla, D, Patil, S, et al. Caesarean section in a case of systemic lupus erythematosus. Indian J Anaesth 2014;58:193–195.Google Scholar
Miner, JJ, Kim, AH. Cardiac manifestations of systemic lupus erythematosus. Rheum Dis Clin North Am 2014;40:51–60.Google Scholar
Ozaki, M, Minami, K, Shigematsu, A. Myocardial ischemia during emergency anesthesia in a patient with systemic lupus erythematosus resulting from undiagnosed antiphospholipid syndrome. Anesth Analg 2002;95:255.Google Scholar
De Virgilio, A, Greco, A, Magliulo, G, et al. Polyarteritis nodosa: a contemporary overview. Autoimmun Rev 2016;15:564–570.Google Scholar
Mahr, A, Guillevin, L Poissonnet, M, et al. Prevalences of polyarteritis nodosa, microscopic polyangiitis, Wegener’s granulomatosis and Churg-Strauss syndrome in a French urban multi-ethnic population in 2000: a capture-recapture estimate. Arthritis Rheum 2004;51:92–99.Google Scholar
Lightfoot, RW Jr, Michel, BA, Bloch, DA, et al. The American College of Rheumatology 1990 criteria for the classification of polyarteritis nodosa. Arthritis Rheum 1990;33:1088–1092.Google Scholar
Pagnoux, C, Seror, R, Henegar, C, et al. Clinical features and outcomes in 348 patients with polyarteritis nodosa: a systematic retrospective study of patients diagnosed between 1963–2005 and entered into the French Vasculitis Study Group Database. Arthritis Rheum 2010;62:616–626.Google Scholar
Pagnoux, C, Mahendira, D, Laskin, CA. Fertility and pregnancy in vasculitis. Best Pract Res Clin Rheumatology 2013;27:79–94.Google Scholar
Gatto, M, Iaccarino, L, Canova, M, et al. Pregnancy and vasculitis: a systematic review. Autoimmuno Rev 2012;11:A447–A459.Google Scholar
Ross, C, D’Souza, R, Pagnoux, C. Pregnancy outcomes in systemic vasculitides. Curr Rheumatol Rep 2020;22:63–76.Google Scholar
Damain, L, Pamfil, C, Fodor, M. Polyarteritis nodosa in pregnancy. Ochsner Journal 2018;18:94–97.Google Scholar
Chifflot, H, Fautrel, B, Sordet, C, et al. Incidence and prevalence of systemic sclerosis: a systematic literature review. Semin Arthritis Rheum 2008;73;223–235.Google Scholar
Meier, FMP, Frommer, KW, Dinser, R, et al. Update on the profile of the EUSTAR cohort: an analysis of the EULAR Scleroderma Trials and Research group database. Ann Rheum Dis 2012;71;1355–1360.Google Scholar
van den Hoogen, F, Khanna, D, Fransen, J, et al. 2013 classification criteria for systemic sclerosis: an American College of Rheumatology/European League against Rheumatism collaborative initiative. Arthritis Rheum 2013;65;2737–2747.Google Scholar
Avouac, J, Airo, P, Meune, C, et al. Prevalence of pulmonary hypertension in systemic sclerosis in European Caucasians and metaanalysis of 5 studies. J Rheumatol 2010;37:2290–2298.Google Scholar
Valentini, G, Paone, C, La Montagna, G, et al. Low-dose intravenous cyclophosphamide in systemic sclerosis: an open prospective efficacy study in patients with early diffuse disease. Scand J Rheumatol 2006;35:35–38.Google Scholar
Seibold, JR, Korn, JH, Simms, R, et al. Recombinant human relaxin in the treatment of scleroderma. Ann Intern Med 2000;132;871–879.Google Scholar
Steen, VD, Medsger, TA. Changes in causes of death in systemic sclerosis, 1972–2002. Ann Rheum Dis 2007;66:940–944.Google Scholar
Ferri, C, Valentini, G, Cozzi, F, et al. Systemic sclerosis; demographic, clinical and serologic features and survival in 1,012 Italian patients. Medicine (Baltimore) 2002;81 :139–153.CrossRefGoogle Scholar
Scussel-Lonzetti, L, Joyal, F, Raynauld, JP, et al. Predicting mortality in systemic sclerosis; analysis of a cohort of 309 French Canadian patients with emphasis on features at diagnosis as predictive factors for survival. Medicine (Baltimore) 2002;81:154–167.Google Scholar
Rothfield, N, Kurtzman, S, Vazquez-Abad, D, et al. Association of anti-topoisomerase I with cancer. Arthritis Rheum 1992;35:724.Google Scholar
Steen, VD. Pregnancy in women with systemic sclerosis. Obstet Gynecol 1999;94:15–20.Google Scholar
Clark, K, Etomi, O, Ong, V. Systemic sclerosis in pregnancy. Obstet Med 2020;13:105–111.Google Scholar
Bernatsky, S, Hudson, M, Pope, J, et al. Assessment of reproductive history in systemic sclerosis. Arthritis Rheum 2008;59 :1661–1664.Google Scholar
Lidar, M, Langevitz, P. Pregnancy issues in scleroderma. Autoimmun Rev 2012;11:515–519.Google Scholar
Munira, S, Christopher-Stine, L. Pregnancy in myositis and scleroderma. Best Pract Res Clin Obstet Gynaecol 2020;64:59–67.CrossRefGoogle ScholarPubMed
Blagojevic, J, Al Odhaibi, KA, Aly, AM, et al. Pregnancy in systemic sclerosis: results of a systematic review and metaanalysis. J Rheumatol 2020;47 :881–887.Google Scholar
Taraborelli, M, Ramoni, V, Brucato, A, et al. Brief report: successful pregnancies but a higher risk of preterm births in patients with systemic sclerosis: an Italian multicenter study. Arthritis Rheum 2012;64;1970–1977.CrossRefGoogle ScholarPubMed
Branch, DW. Pregnancy in patients with rheumatic diseases: obstetric management and monitoring. Lupus 2004;13 :696–698.Google Scholar
Moore, M, Saffran, JE, Baraf, HS, et al. Systemic sclerosis and pregnancy complicated by obstructive uropathy. Am J Obstet Gynecol 1985;153;893–894.Google Scholar
Bellucci, MJ, Coustan, DR, Plotz, RD. Cervical scleroderma; a case of soft tissue dystocia. Am J Obstet Gynecol 1984;150;891–892.Google Scholar
Thompson, J, Conklin, KA. Anesthetic management of a pregnant patient with scleroderma. Anesthesiology 1983;59;69–71.Google Scholar
Dempsey, ZS, Rowell, S, McRobert, R. The role of regional and neuraxial anesthesia in patients with systemic sclerosis. Local Reg Anesth 2011;4:47–56.Google Scholar
Lewis, GB. Prolonged regional analgesia in scleroderma. Can Anaesth Soc J 1974;21:495–497.Google Scholar
Neill, RS. Progressive systemic sclerosis. Prolonged sensory blockade following regional anaesthesia in association with a reduced response to systemic analgesics. Br J Anaesth 1980;52:623–625.Google Scholar
Eisele, JH, Reitan, JA. Scleroderma, Raynaud’s phenomenon, and local anesthetics. Anesthesiology 1971;34:386–387.Google Scholar
Lee, GY, Cho, S. Spinal anesthesia for cesarean section in a patient with systemic sclerosis associated interstitial lung disease: a case report. Korean J Anesthesiol 2016;69:406–408.Google Scholar
Bailey, AR, Wolmarans, M, Rhodes, S. Spinal anaesthesia for caesarean section in a patient with systemic sclerosis. Anaesthesia 1999;54:350–371.Google Scholar
Younker, D, Harrison, B. Scleroderma and pregnancy; anaesthetic considerations. Br J Anaesth 1985;57:1136–1139.Google Scholar
D’Angelo, R, Miller, R. Pregnancy complicated by severe preeclampsia and thrombocytopenia in a patient with scleroderma. Anesth. Analg 1997;85:839–841.Google Scholar
Hseu, SS, Sung, CS, Mao, CC, et al. Anesthetic management in a parturient with progressive systemic sclerosis during caesarean section – a case report. Acta Anaesthesiol Sin 1997;35:161–166.Google Scholar
Moaveni, D, Cohn, J, Brodt, K, et al. Scleroderma and pulmonary hypertension complicating two pregnancies: use of neuraxial anesthesia, general anesthesia, epoprostenol and a multidisciplinary approach for cesarean delivery. Int J Obstet Anesth 2015;24;375–382.Google Scholar
Zöller, B, Li, X, Sundquist, J, et al. Risk of pulmonary embolism in patients with autoimmune disorders: a nationwide follow up study from Sweden. Lancet 2012;379:244–249.Google Scholar
Miyakis, S, Lockhin, MD, Atsumi, T, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006;4:295–306.Google Scholar
Carp, HJA. Antiphospholipid syndrome in pregnancy. Curr Opin Obstet Gynecol 2004;16:129–135.Google Scholar
Cervera, R, Serrano, R, Pons-Estel, GJ, et al. Morbidity and mortality in antiphospholipid syndrome during a 10-year period: a multicentre prospective study of 1000 patients. Ann Rheum Dis 2015;74:1011–1018.Google Scholar
de Jesus, GR, Agmon-Levin, N, Andrade, CA, et al. 14th International congress on antiphospholipid antibodies task force report on obstetric antiphospholipid syndrome. Autoimmun Rev 2014;13:795–813.Google Scholar
Cervera, R, Piette, JC, Font, J, et al. Antiphospholipid syndrome: clinical and immunological manifestation and patterns of disease expression in a cohort of 1000 patients. Arthritis Rheum 2002;46:1019–1027.Google Scholar
Parke, A. Short- and long-term maternal outcomes in patients with phospholipid antibodies. Lupus 2004;13:703–704.Google Scholar
Erkan, D, Asherson, RA, Espinosa, G, et al. Long-term outcome of catastrophic syndrome survivors. Ann Rheum Dis 2003;62 :530–533.Google Scholar
Asherson, RA, Cervera, R, Piette, JC, et al. Catastrophic antiphospholipid syndrome: clinical and laboratory features of 50 patients. Medicine (Baltimore) 1998;77:195–207.Google Scholar
Kutteh, WH. Antiphospholipid antibodies and reproduction. J Reprod Immunol 1997;35:151–171.Google Scholar
Vinatier, D, Dufour, P, Cosson, M, et al. Antiphospholipid syndrome and recurrent miscarriages. Eur J Obstet Gynecol Reprod Biol 2001;96:37–50.Google Scholar
Derksen, RH. Khamashta, MA, Branch, DW. Management of the obstetric antiphospholipid syndrome. Arthritis Rheum 2004;50:1028–1039.Google Scholar
Saccone, G, Berghella, V, Maruotti, GM, et al. Antiphospholipid antibody profile based obstetric outcomes of primary antiphospholipid syndrome: the PREGNANTS study. Am J Obstet Gynecol 2017;216:525.e1–525.e12.Google Scholar
Arslan, E, Branch, DW, James, R, et al. Antiphospholipid syndrome: diagnosis and management in the obstetric patient. Best Pract Res Clin Obstet Gynaecol 2020;64:31–40.Google Scholar
De Carolis, S, Moresi, S, Rizzo, F, et al. Autoimmunity in obstetrics and autoimmune disease in pregnancy. Best Pract Res Clin Obstet Gynaecol 2019;60:66–76.Google Scholar
Rawat, RS, Dehran, M. Anaesthetic management of a pregnant patient with antiphospholipid antibody syndrome for emergency caesarean section. Int J Obstet Anesth 2003;12:311.Google Scholar
Ringrose, DK. Anaesthesia and the antiphospholipid syndrome; a review of 20 obstetric patients. Int J Obstet Anesth 1997;6:107–111.Google Scholar
Ralph, CJ. Anaesthetic management of parturients with the antiphospholipid syndrome; a review of 27 cases. Int J Obstet Anesth 1999;8:249–252.Google Scholar
Shah, S, Parasar, K, Cohen, S, et al. Haemorrhage during caesarean section for parturient with antiphospholipid syndrome. J Obstet Anaesth Crit Care 2015;5:93–94.Google Scholar
Bilal, RM, Riaz, A, Khan, RAS. Ruptured ectopic pregnancy with APLA syndrome – a case report. Anaesth Pain & Intensive Care 2014;18:461–463.Google Scholar
Yelnik, CM, Lambert, M, Drumez, E, et al. Bleeding complications and antithrombotic treatment in 264 pregnancies in antiphospholipid syndrome. Lupus 2018;27:1679–1686.Google Scholar
Ihle, BU, Oziemski, P. Multiorgan failure secondary to catastrophic anti-phospholipid syndrome. Anaesth Intensive Care 2002;30:82–85.Google Scholar
Dorman, RIP. Acute postoperative biventricular failure associated with antiphospholipid antibody syndrome. Br J Anaesth 2004;92:748–754.Google Scholar
Ozaki, M, Ogata, M, Yokoyama, T, et al. Prevention of thrombosis with prostaglandin E1 in a patient with catastrophic antiphospholipid syndrome. Can J Anesth 2005;52:143–147.Google Scholar
Batra, Y. Anesthetic implications of the catastrophic antiphospholipid syndrome. Pediatric Anesth 2006;16:1090–1093.Google Scholar
Sellner, J, Kraus, J, Awad, A, et al. The increasing incidence and prevalence of female multiple sclerosis: a critical analysis of potential environmental factors. Autoimmun Rev 2011;10:495–502.Google Scholar
Goodwin, DS. The epidemiology of multiple sclerosis: insights to disease pathogenesis. Handb Clin Neurol 2014;122:231–266.Google Scholar
Compston, A, Coles, A. Multiple sclerosis. Lancet 2008;372:1502–1517.Google Scholar
McGinley, MP, Goldschmidt, CH, Rae-Grant, AD. Diagnosis and treatment of multiple sclerosis: a review. JAMA 2021;325:765–779.Google Scholar
Lublin, FD, Reingold, SC, Cohen, JA, et al. Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology 2014;83:278–286.Google Scholar
Thompson, AJ, Banwell, BL, Barkhof, F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the Criteria, McDonald. Lancet Neurol 2018;17:162–173.Google Scholar
Scalfari, A, Knappertz, V, Cutter, G, et al. Mortality in patients with multiple sclerosis. Neurology 2013;81:184–192.Google Scholar
Confavreux, C, Hutchinson, M, Hours, MM, et al. Pregnancy in Multiple Sclerosis Group. Rate of pregnancy-related relapse in multiple sclerosis. N Engl J Med 1998;339:285–291.Google Scholar
Finkelsztejn, A, Brooks, JBB, Paschoal, FM, et al. What can we really tell women with multiple sclerosis regarding pregnancy? A systematic review and meta-analysis of the literature. BJOG 2011;118:790–797.Google Scholar
Ferrero, S, Pretta, S, Ragni, N. Multiple sclerosis: management issues during pregnancy. Eur J Obstet Gynecol Reprod Biol 2004;115:3–9.Google Scholar
Michel, L, Foucher, Y, Vukusic, S, et al. Increased risk of multiple sclerosis relapse after in vitro fertilisation. J Neurol Neurosurg Psychiatry 2012;83:796–802.Google Scholar
Vukusic, S, Marignier, R. Multiple sclerosis and pregnancy in the ‘treatment era’. Nat Rev Neurol 2015;11:280–289.Google Scholar
Dobson, R, Jokubaitis, VG, Giovannoni, G. Change in pregnancy-associated multiple sclerosis relapse rates over time: a meta-analysis. Mult Scler Relat Disord 2020;44:102241.Google Scholar
Hughes, SE, Spelman, T, Gray, OM, et al. Predictors and dynamics of postpartum relapses in women with multiple sclerosis. Mult Scler 2014;20:739.Google Scholar
Pakpoor, J, Disanto, G, Lacey, MV, et al. Breastfeeding and multiple sclerosis relapses: a meta-analysis. J Neurol 2012;259:2246–2248.Google Scholar
Hellwig, K, Rockhoff, M, Herbstritt, S, et al. Exclusive breastfeeding and the effect on postpartum multiple sclerosis relapses. JAMA Neurol 2015;72:1132–1138.Google Scholar
Dobson, R, Dassan, P, Roberts, M, et al. UK consensus on pregnancy in multiple sclerosis: ‘Association of British Neurologists’ guidelines. Pract Neurol 2019;19:106–114.Google Scholar
Canibano, B, Deleu, D, Mesraoua, B, et al. Pregnancy-related issues in women with multiple sclerosis: an evidence-based review with practical recommendations. J Drug Assess 2020;9:20–36.Google Scholar
Drake, E, Drake, M, Dird, J, et al. Obstetric regional blocks for women with multiple sclerosis: a survey of UK experience. Int J Obstet Anesth 2006;15:115–123.Google Scholar
Pasto, L, Portaccio, E, Ghezzi, A, et al. Epidural analgesia and caesarean delivery in multiple sclerosis post-partum relapses: the Italian cohort study. BMC Neurology 2012;12:7. https://doi.org/10.1186/1471-2377-12-165Google Scholar
Dalmas, AF, Texier, C, Ducloy-Bouthors, AS, et al. Obstetrical analgesia and anaesthesia in multiple sclerosis. Annales Francaises D Anesthesie Et De Reanimation 2003;22:861–864.Google Scholar
Lavie, C, Rollot, F, Durand-Dubief, F, et al. Neuraxial analgesia is not associated with an increased risk of post-partum relapse in MS. Mult Scler 2019;25:591–600.Google Scholar
Lu, E, Zhao, Y, Dahlgren, L, et al. Obstetrical epidural and spinal anesthesia in multiple sclerosis. J Neurol 2013;260:2620–2628.Google Scholar
Harazim, H, Stourac, P, Janku, P, et al. Obstetric anesthesia/analgesia does not affect disease course in multiple sclerosis: 10-year retrospective cohort study. Brain Behav 2018;8:e1082. https://doi.org/10.1002/brb3.1082Google Scholar
Perinpanayagam, J, Powell, J, Hammand, S, et al. Regional anaesthesia and postpartum relapse for obstetric patients with multiple sclerosis: a case series. Int J Obstet Anesth 2019;39:30–31.Google Scholar
Bouvet, L, Chassard, D, Fontana, M, et al. Post-partum relapse in women with multiple sclerosis after neuraxial labour analgesia or neuraxial anaesthesia: a multicentre retrospective cohort study. Anaesth Crit Care Pain Med 2021;19:100834. https://doi.org/10.1016/j.accpm.2021.100834Google Scholar
Makris, A, Piperopoulos, A, Karmaniolou I. Multiple sclerosis: basic knowledge and new insights in perioperative management. J Anaesth 2014;28:267–278.Google Scholar
Caminero, A, Bartolome, M. Sleep disturbances in multiple sclerosis. J Neurol Sci 2011;309:86–91.Google Scholar

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