Systemic lupus erythematosus (SLE) is an autoimmune disease most frequently found in women of childbearing age and may coexist with pregnancy. Disease exacerbation, increased fetal loss, neonatal lupus, and an increased incidence of preeclampsia are the major challenges. Its multisystem involvement and therapeutic interventions like anticoagulants, steroids, and immunosuppressive agents pose a high risk for both the mother and the fetus during the antenatal period as well as postpartum. Good multidisciplinary medical care is mandatory when detection or flare-up of SLE occurs during pregnancy.We describe the successful management of an antinuclear antibody, antiribonucleoprotein antibody, and anti-Sjogren's syndrome A (Ro) antibody positive parturient with bad obstetric history who underwent elective cesarean section and delivered a healthy child.

Rheumatic mitral stenosis is the most common acquired valvular lesion in pregnant women. The overall mortality is 1%, but can go up to 5% in those patients with New York Heart Association class III and IV symptoms. Percutaneous mitral balloon valvuloplasty (PMBV) is the procedure of choice in the treatment of rheumatic mitral stenosis. The PMBV is usually done in the first or second trimester, but in the third trimester, PMBV is a less common procedure.A 24-year-old gravida 2 para 1 living 1 with 35 weeks of gestation with previous lower segment cesarean section (LSCS) presented with breathlessness and swelling of lower limbs. Evaluation revealed rheumatic mitral stenosis of moderate severity with moderate mitral regurgitation with cardiac failure. Hence, PMBV was done, which resulted in increase of mitral valve area from 0.6 to 1.7 cm 2 . She had marked symptomatic improvement, and cesarean section was done at 36 weeks 5 days for previous LSCS with preterm premature rupture of membranes. The postoperative period was uneventful.Our report reinforces the fact that third trimester PMBV is safe and effective during pregnancy with no untoward effect on the fetus.

No abstract