Rheumatology‎ > ‎

Pregnancy issues

Physiological changes 
  • IV volume increases by 30-50% 
  • GFR increases by 50% so that pre-existing proteinuria will get worse 
  • Prothrombotic state, estrogen induced hypercoaguability, venous stasis, compression from gravid uterus increase the risk of VTE by 5 fold 
  • RBC mass increases to a lesser extent than plasma volume, hemodiulution anemia 
  • Increased progesterone reduces GI motilityand sphincter tone, added by uterine compression, GERD occurs in 80% of pregnant patients  
  • slow gi transit time exacerbates constipation in patients with Systemic Sclerosis 
  • pregnancy related rash can be confused with autoimmune rash 
    • facial and palmar erythema caused by preg- nancy-induced vasodilatation mimicking inflammatory rash
    • Chloasma gravidarum, an estrogen-induced facial hyperpigmentation, may similarly suggest a malar rash
  • Hormone-induced ligamentous laxity often causes arthralgias.