Women with rheumatic diseases may well face unique challenges during pregnancy and are often at increased risk of complications including pre-eclampsia, fetal growth restriction and preterm delivery. With careful management and anticipation of these complications, along with multidisciplinary team involvement, these pregnancies can be successful. There have been a number of updates recently to the US, European and UK guidelines on therapies to manage rheumatic disease in pregnancy, and these will be addressed in this talk.