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Preconception evaluation of couples wishing to conceive is an important step toward a healthy pregnancy and it is especially important in people with a chronic condition or at genetic risk. The most common endocrine disorders in women at reproductive age are those involving the thyroid gland and it is well recognized that hyperthyroidism (HT), over-function of the thyroid gland, is associated with risks of maternal, fetal, and neonatal complications. The aim of this paper is to review the latest evidence regarding the components of preconception counseling in women with HT that contemplate a pregnancy. We also want to raise awareness among healthcare professionals about the importance of periconceptional counseling in improving pregnancy outcomes and avoid maternal and fetal complications related to thyroid dysfunction. In women with Graves' disease seeking pregnancy, it is essential to discuss all the treatment options along with the associated risks and benefits. Extensive prospective studies are still needed to understand the implications of current recommended strategies for the management of HT in preconception and during pregnancy. [ABSTRACT FROM AUTHOR]

Highlights: What are the main findings? Unified, practical approach for preconception counselling of SLE women. What is the implication of the main finding? What can be learned by the rheumatologist: the need for early referral for preconception counselling, risk stratification including from obstetrical point of view (preeclampsia (PE), anaesthetic evaluation), in vitro fertilisation, allowed medication during pregnancy (SLE-specific or non-specific), the need to evaluate for other autoimmune conditions includ-ing for thyroid disease. What can be learned by the obstetrician: how to assess activity and damage in SLE including scoring, autoantibody evaluation, and allowed vaccination from the SLE point of view. Pregnancy is one of the most challenging processes the human body is exposed to: the healthy mother can carry to term a genetically different new-born, while her immune system adapts to tolerate this new status and avoids rejection. In autoimmune disorders, motherhood is even more challenging, with additional medical counselling, mother care, and foetus development checks being necessary. While the aspects of supplementary mother care and pregnancy progress tracking are associated with well-established medical procedures and protocols, counselling, be it pre- or post-conception, is still underestimated and scarcely applied. Indeed, over the past decades, medical counselling for this particular population has changed significantly, but from a healthcare's provider point of view, more is required to ensure a smooth, controllable pregnancy evolution. One of the most frequent autoimmune diseases affecting young females during their fertile years is Systemic Lupus Erythematosus (SLE). Like other heterogenous diseases, it exposes the mother to severe, organ-threatening complications and unpredictable evolution. Both the disease and its treatment can significantly affect the mother's willingness to engage in a potentially risky pregnancy, as well as the likeliness to carry it to term without any impairments. A good collaboration between the patient's rheumatologist and obstetrician is therefore mandatory in order to: (a) allow the mother to make an informed decision on pursuing with the pregnancy; (b) ensure a perfect synchronization between pregnancy terms and treatment; and (c) avoid or minimize potential complications. The best approach to achieve these outcomes is pregnancy planning. Moreover, knowing one desired prerequisite for a successful pregnancy evolution in SLE mothers is a stable, inactive, quiescent disease for at least six months prior to conception, planning becomes more than a recommended procedure. One particular aspect that requires attention before conception is the treatment scheme applied before delivery as autoantibodies can influence significantly the course of pregnancy. In this view, future SLE mothers should ideally benefit from preconception counselling within their agreed care pathway. A multidisciplinary team including at least the rheumatologist and obstetrician should be employed throughout the pregnancy, to decide on the appropriate timing of conception and compatible medication with respect to disease activity, as well as to monitor organ involvement and foetus development progress. [ABSTRACT FROM AUTHOR]

Background. Women are commonly diagnosed with multiple sclerosis during reproductive age. There is need for disease control management during pregnancy, taking into consideration potential maternal and fetal risks. This review article aims to summarize what is acknowledged so far regarding treatment options of multiple sclerosis and outcomes in pregnancy, providing up-to-date information. Methods. In order to write this review a comprehensive literature electronic search for journal articles and guidelines regarding multiple sclerosis during pregnancy was undertaken. Results and conclusion. Multiple sclerosis management in pregnancy is a challenging issue. The use of disease-modifying drugs has improved both the course of the disease and the attitude towards pregnancy in patients living with multiple sclerosis. Pregnancy appears to have a protective effect on disease activity, particularly during the third trimester. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) has rapidly become a global pandemic with a devastating morbidity and mortality. Pregnant women seem to be at increased susceptibility to have a severe disease and suffer adverse pregnancy outcomes. The only solution to mitigate this pandemic is prophylaxis by mass vaccination. We report a review based on current literature about the evidence available on efficacy and safety of anti-COVID-19 vaccines in pregnancy to aid women decide whether to vaccinate or not, while being pregnant or lactating. Studies so far did not find concerning maternal or fetal outcomes and show a similar efficiency of mRNA vaccines as in non-pregnant population. Moreover, anti-SARS-CoV-2 antibodies resulted from the vaccination seem to be transferred to the newborn through the placenta or the breastmilk building up the neonatal immunity. However, the exclusion from clinical trials created a great deficiency of evidence regarding the vaccination in this high-risk population resulting in their reluctance. [ABSTRACT FROM AUTHOR]

When it has been declared a global epidemic, HIV infection became a challenge for medical world. Even if there is only one healed case cited in literature, treatment for HIV-infection have evolved during time leading to very good results in disease control and limitation of virus transmission. When it comes for viral transmission, an essential research topic became the prevention of mother to fetal transmission. In the long run, many discovered antiretroviral drugs proved to be efficient in controlling HIV infection during pregnancy and thereby in reducing the risk of viral transmission to the fetus. But along with use of the HIV-treatment in pregnancy, many questions have appeared. Are the drugs safe for the fetus, or are there any adverse pregnancy outcomes? Should the treatment be adjusted for the desired results in pregnancy, or should the initial treatment be changed when the pregnancy is diagnosed? Many retrospective or prospective observational studies and comparative studies have been conducted in order to answer those questions and to analyze the efficacy and the safety of mostly used antiretroviral drugs in pregnancy. This article reviews the existing studies, guidelines and recommendations regarding the combined antiretroviral HIV treatment during pregnancy for fetal infection prevention. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD), with its two main forms, Crohn’s disease, and ulcerative colitis, are characterized by chronic inflammation of the gastrointestinal tract. It is frequently diagnosed during childbearing years and its overlapping with pregnancy adds more complexity to the management of the disease. This review article aims to summarize what is acknowledged so far regarding IBD in pregnancy, providing up-to-date information. A systematic literature electronic search for journal articles and guidelines regarding IBD during pregnancy was undertaken. The most favorable pregnancy outcomes for pregnant women with IBD occur when the disease is in remission both at the time of conception and during the pregnancy. Most of IBD medication is considered safe during pregnancy and continuing therapy in pregnancy is fundamental for achieving optimal outcomes. Proper management of active IBD in pregnancy requires multidisciplinary care to lower adverse outcomes. There is insufficient knowledge among patients regarding how their pregnancy outcomes could be optimized. [ABSTRACT FROM AUTHOR]

Uterine fibroids are the most common benign tumors affecting female genital tract, responsible for a high morbidity across fertile age women, with a prevalence of 0,1-11% among pregnant women. Although generally asymptomatic, they can lead to a series of symptoms and complications such as pain, infertility, miscarriages, antenatal bleeding, postpartum hemorrhage, preterm labor, fetal malpresentation, placental abruptio and high cesarean section rates. The purpose of review is to update information regarding fibroids specifications and their correlation with pregnancy outcomes as well as fibroids management during pregnancy. Because of uterine fibroids heterogeneity and lack of large, randomized trials there are encountered discrepancies among studies, but it was observed that uterine fibroids increase the risks of negative obstetrical outcomes, especially when it goes to large, multiple, submucous and retroplacental myomas. Conservative management during pregnancy is advised, but in special situations myomectomy could be recommended and possible. Trial of labor should be offered to pregnant women even if they have large uterine fibroids, or previous myomectomy excepting fibroids obstructing the birth canal or patients who underwent extensive surgery for fibroids removal. [ABSTRACT FROM AUTHOR]