Lupus and Pregnancy: Complex Yet Manageable

Abstract

Systemic lupus erythematosus is a chronic multi-system autoimmune disease that occurs predominantly in women of childbearing age. The risk of complications and adverse fetal outcomes in pregnant women with lupus is high. Moreover, pregnancy can cause flares of lupus disease activity necessitating maternal immunosuppressive intervention. Interestingly, many potential complications of pregnancy present as symptoms of lupus making diagnosis and treatment a challenge.Advancing technology and better understanding of the maternal-fetal dyad in lupus have improved outcomes in lupus pregnancies over the last 40 years. This article will briefly review the important issues in pregnancies complicated by lupus and provide a general guideline to physicians for monitoring and treatment.

Vasculitic Neuropathy in a Third Trimester Pregnant Patient with Systemic Lupus Erythematosus

“…Both the central and peripheral nervous system can be affected with a wide variety of neuropsychiatric complications such as mood disorders, cognitive disorders, myelopathy, movement disorders, peripheral neuropathies. SLErelated neurological involvement can be seen nearly 19-75% of patients (1,2). Neuropathy develops in approximately 5% of all cases of SLE.…”

“…Systemic Lupus Erythematosus (SLE) is an important systemic disease with high morbidity and mortality (1). As one of the causes of secondary vasculitis, this autoimmune inflammatory disease can show a wide variety of systemic manifestations.…”

Serum markers thrombophilia in pregnant women with Systemic Lupus Erythematosus

“…By the other hand, dexamethasone should enter fetal circulation, so that it becomes the best choice in treatment of congenital heart block. 2 The objective of the present study was to determine the frequency of serum markers for hereditary and acquired thrombophilia and antiphospholipid antibodies and to examine their association with pregnancy in women with SLE.…”

“…1 It is a serious disease with significant mortality and morbidity, and approximately 90% of affected patients are women of childbearing age. 2 The disease has a variety of signs and symptoms that are often unspecific, thereby making its diagnosis difficult. The diagnosis of SLE is made when at least four of the 17 criteria defined by the American College of Rheumatology for SLE are present (Table 1).…”

“…3 As the manifestations of a normal pregnancy may sometimes be confused with lupus activity, it is important to understand the changes that occur during pregnancy. 2 During normal pregnancy, changes occur in clotting factors, which result in protein S deficiency, increased fibrinogen levels, and changes in factor II and factor VII. These changes increase the risk of thromboembolism by five-fold.…”