Treating rheumatic diseases in pregnancy: dos and don'ts.

This paper presents a critical appraisal of the current evidence and recommendations regarding the use of pharmaceuticals and biologicals in pregnancy. Clinical experience is often at variance with published recommendations as studies have not taken into account the differences in physiology in the various stages of gestation and between animal and human pregnancies. Physicians should bear in mind that pregnancy causes disruption in several organ systems; the effects of an intervention may depend on the stage of gestation; and some effects of interventions in pregnancy may not manifest until adulthood.