From: Managing pregnancy in inflammatory rheumatological diseases
Disease | Complications that may affect use of analgesia and anesthesia |
---|---|
Systemic lupus erythematosus | Pericarditis or valvular abnormalities |
Pulmonary hypertension, pleural effusions, or lupus pneumonitis | |
Peripheral neuropathies, central nervous system dysfunction (seizures), or psychological problems | |
Hematological abnormalities (anemia, thrombocytopenia, or coagulopathy) | |
Lupus nephritis | |
Antiphospholipid syndrome | Coexisting autoimmune disease, secondary organ involvement, and thrombotic phenomena, including pulmonary |
hypertension | |
Anticoagulation | |
Rheumatoid arthritis | Cervical spine involvement (exclude atlantoaxial anterior subluxation and avoid excessive manipulation of neck during general anesthesia) |
Hip disease that might prevent vaginal delivery | |
Pleural/pericardial effusions and pulmonary parenchymal involvement | |
Ankylosing spondylitis | Assess presence of extra-articular (cardiopulmonary) features and use of opiate analgesics |
Temporo-mandibular joint dysfunction, cervical and lumbar spine (for general, epidural, or spinal anesthesia), and hip | |
involvement (for vaginal delivery) | |
Systemic sclerosis | Renal disease, systemic hypertension, pulmonary hypertension, or cardiac dysfunction |
Assess peripheral pulses, peripheral venous access, extent of Raynaud phenomenon, and skin involvement | |
Vasculitis | Organ ischemia (cardiac, renal, cerebral, and limb) and intravascular volume |
Monitor hypertension and end organ complications or thrombosis |