الفهرس 
Introduction and Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
Many rheumatologic disorders impact women during their childbearing years. Currently, there is limited ability to predict which patients will go into remission during pregnancy and which patients will flare. Furthermore, data on medication safety are often limited or incomplete. As we better understand the immune mechanisms that underlie these diseases, we will hopefully have a deeper awareness of the way in which pregnancy modulates disease activity. Furthermore, drug development may lead to newer therapies that present limited risk to the fetus and newborn and therefore may be used with impunity during pregnancy and lactation.Recommendations on prescribing during pregnancy and lactation differ, sometimes considerably, in articles and textbooks. Even the recommendations given by the producer of a given drug can vary in different countries. This situation is unsatisfying for both the patient and the treating physician .Due to limited human pregnancy experience safety issues in regard to children exposed antenatally to biological drugs are still under debate. A survey of new published experience on biological agents during pregnancy is necessary to assist clinicians with adequate counseling and management of patients who desire children.The use of antirheumatic drugs like DMARD in RA+CVH (chronic viral hepatitis) is associated with a high incidence of hepatotoxicity. The effect is likely to be synergistic. It may not be absolutely safe even with supposedly less hepatotoxic agents such as HCQ. Judicious use of DMARDs and cautious monitoring are necessary. Large-scale prospective clinical trials of DMARD use in RA patients with concomitant CVH should be performed.