Management of Pregnant Women with Positive Antibody Screens

Introduction to Antibody Management

• The American College of Rheumatology recommends referral to maternal-fetal medicine or high-risk OB-GYN for pregnant women with Anti-Ro/SSA or Anti-La/SSB antibodies, requiring co-management with rheumatology and obstetric specialists, serial fetal echocardiography, and potential hydroxychloroquine therapy 1, 2
• The American College of Rheumatology suggests that antiphospholipid antibodies necessitate referral to maternal-fetal medicine, requiring anticoagulation and close monitoring 1, 2

HIV Management in Pregnancy

• The Centers for Disease Control and Prevention recommends immediate referral to providers experienced in HIV care during pregnancy for HIV-positive women, requiring combination antiretroviral therapy, viral load monitoring, and consideration of cesarean delivery at 38 weeks 3, 4, 5

Autoimmune Antibody Management

• The American College of Rheumatology indicates that autoimmune antibodies, such as Anti-Ro/SSA and antiphospholipid antibodies, require entirely different management than blood group antibodies, necessitating specialist co-management regardless of Rh status 1, 2