Pregnancy and child birth in SLE patients can be complicated by disease activity, lupus nephritis, gestational diabetes, hypertensive disorders, intrauterine growth retardation, placental abruption, intrauterine and neonatal death, birth asphyxia, neonatal lupus and maternal mortality. AIMS AND OBJECTIVES: To find out 1) The most common complications and their incidence. 2) Maternal and fetal outcome in SLE patients during pregnancies. Study design; Prospective observational study. MATERIALS AND METHODS: Patients are enrolled for the study from pregnant mothers with known as well as newly diagnosed SLE who are attending outpatient department of obstetrics and gynecology department of Institute of maternal and child health, Calicut Government Medical college from 2011 February to 2012 June (18 months). Data collected from available past medical records, interview, physical examination, progress records and laboratory investigations of patients using predesigned proforma. RESULTS: Of the total 40 patients enrolled in the study, 45% were in the age group 26-30. 25% had one abortion in the past and 2 patients had 3 abortions. 65% had the disease for more than 6 years. Prior to the present pregnancy, 95% patients were in remission. During the present pregnancy 25 % patients had active lupus nephritis and 20% had flare. 25% and 75% patients had gestational diabetes mellitus and hypertensive disorders respectively. The incidence of intra uterine growth retardation was 45%. Placental abruption occurred in 10% pregnancies. The incidence of intrauterine death (25%) was higher than that of neonatal deaths (10%). 20% babies had birth asphyxia and the incidence of low birth weight was very high (60%). 10% mothers had flare and 10% babies neonatal lupus. Maternal mortality was 5%. CONCLUSION: The study highlights the increased incidence of complications associated with pregnancies in SLE and thus the need for high quality care for better maternal and fetal outcome.

To evaluate the various causes of perinatal deaths and adopt strategies to improve perinatal outcome at a referral teaching hospital in North Kerala. METHODS: A prospective observational study conducted at Institute of Maternal and Child Health, Government Medical College, Kozhikode. All perinatal deaths during the period January 2013 to December 2014 were analysed and from this factors responsible for perinatal deaths were identified. RESULTS: Out of total 30,042 deliveries, there were 966 perinatal deaths during the study period. 566 were still births and 400 early neonatal deaths. The perinatal mortality rate was 31.1 per 1000 live births. Perinatal asphyxia was the major cause of perinatal mortality. The important factors contributing to perinatal asphyxia were prematurity (39%), abruptio placenta (19%) and MSAF (12%). Among the antenatal factors, hypertensive disorders of pregnancy leading to iatrogenic elective preterm delivery were the most important. CONCLUSION: Perinatal asphyxia due to prematurity and low birth weight emerged as the most important cause of perinatal mortality in this study and hypertensive disorders of pregnancy were the most important antenatal complication leading to prematurity.