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Table 3 Disease-specific complications that may affect use of analgesia and anesthesia

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
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