Pregnancy in Women With Systemic Lupus and Lupus Nephritis

Maynard, Sharon; Md, Grace Guerrier; Duffy, Margaret

doi:10.1053/j.ackd.2019.08.013

Cited by 24 publications

(15 citation statements)

References 58 publications

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“…8 An increased risk of developing preeclampsia and LN was also found in previous studies. 9,27 APS is frequently seen in patients with SLE and may result in various pregnancy-related complications. APS was found in 16.78% of the pregnancies in the current cohort.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy Outcomes in Systemic Lupus Erythematosus Women

Al-Riyami

Salman

Al-Rashdi

et al. 2021

Sultan Qaboos Univ Med J

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Objectives: This study was conducted to assess pregnancy outcomes in women with systemic lupus erythematosus (SLE) in Oman. Methods: A retrospective cohort study of 149 pregnancies in 98 women with SLE was conducted over 10 years to evaluate the impact of clinical and laboratory parameters in predicting adverse pregnancy outcomes. Results: Mean maternal age was 30.6 ± 5 years ranging from 20–44 years, and the mean disease duration was 10 ± 5 years, ranging from 2–27 years. The most common maternal manifestations were joint pain in 36 (24.2%), lupus nephritis (LN) in 18 (12.08%), preeclampsia in 11 (7.4%), eclampsia in three (2%) and lupus flare in one pregnancy. The live birth rate was 139 (93.3%) with a mean gestational age of 36 ± 2 weeks ranging from 26–40 weeks. In total, 55 (39.6%) were preterm deliveries, six (4%) pregnancies ended in miscarriage, and four (2.7%) resulted in intrauterine fetal death. Intrauterine growth restriction was observed in 49 babies (35%). A significant association was found between hypertension (HTN) and miscarriage (P = 0.024) and preterm birth (P = 0.019). In addition, HTN was positively associated with preeclampsia (P = 0.004) and LN (P = 0.048). Antiphospholipid syndrome impacted preterm birth (P = 0.013) and postpartem haemorrhage (PPH) (P = 0.027) and was found to be a significant predictor for women developing deep vein thrombosis and pulmonary embolism (P <0.001 for both). Conclusion: Despite potential complications, most pregnancies complicated by SLE in Oman result in good outcomes. Adverse pregnancy outcomes, however, may still occur in women with SLE. In women with SLE, pregnancy planning, careful antenatal monitoring and efficient SLE treatment need to be undertaken for successful pregnancy outcomes. Keywords: Systemic Lupus Erythematosus; Pregnancy Outcomes; Lupus Nephritis; Antiphospholipid Antibodies; Neonatal Lupus.

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Section: Discussionmentioning

confidence: 99%

Pregnancy Outcomes in Systemic Lupus Erythematosus Women

Al-Riyami

Salman

Al-Rashdi

et al. 2021

Sultan Qaboos Univ Med J

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“…O lúpus tem potencial de trazer complicações à gravidez causando CIUR, perda fetal, prematuridade e pré-eclâmpsia. Além disso, pode gerar também danos ao bebê, com o chamado lúpus neonatal, sendo sua manifestação mais grave o lúpus neonatal cardíaco (MAYNARD, et al, 2019).…”

Section: Planejamento Da Gestação Da Mulher Com Lúpus Eritematoso Sistêmicounclassified

Abordagem do lúpus eritematoso sistêmico em gestantes: revisão narrativa

et al. 2021

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Objetivo: Revisar e fornecer uma ampla abordagem sobre o lúpus eritematoso sistêmico durante a gestação e disponibilizar informações atualizadas para que possam ser alcançados melhores desfechos em gestações de alto risco, alcançando um melhor prognóstico materno-fetal. Revisão Bibliográfica: O Lúpus Eritematoso Sistêmico (LES) é a doença autoimune mais comum na gravidez. Sua clínica é bastante variável e, como os sinais e sintomas são muitas vezes inespecíficos, ele pode mimetizar outras doenças e dificultar diagnóstico. É uma doença que pode afetar diversos órgãos em diferentes graus. Como o LES durante a gestação aumenta os riscos maternos e fetais, é importante solicitar exames laboratoriais para melhor controle da gestante. O monitoramento da gravidez deve ser multidisciplinar e inclui avaliação clínica, laboratorial e ultrassonográfica regular. Antes de engravidar, idealmente, a gestação deverá ser planejada. Considerações finais: O lúpus pode trazer malefícios à gestação e ao bebê, assim como a gestação pode exacerbar o lúpus, portanto, recomenda-se à gestante acompanhamento médico rigoroso pré e pós concepção e principalmente durante a gravidez.

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“…Pda ibu hamil terdapat perubahan komposisi dan fungsi sel imunkompeten serta molekul imunomodulator. 3,4 Sitokin merupakan mediator penting yang mendukung kehamilan yang berhasil. Salah satu modifikasi imunologik yang penting dalam kehamilan ialah perubahan sitokin T-helper Th1/Th2.…”

Section: Patofisiologiunclassified

“…Manfaat biopsi ginjal dalam setting suspek LN ialah diagnosis definitif, sehingga dapat diberikan imunosupresi dan kemungkinan prolongasi kehamilan (Tabel 2). 3,11…”

Section: Diagnosisunclassified

Lupus Eritematosus Sistemik (LES) pada Kehamilan

Suparman

2021

eCL

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Systemic lupus erythematosus (SLE) is a multi-organ autoimmune disease that can affect women of childbearing age. Pregnancy causes alterations of the immune and neuroendocrine systems. Moreover, SLE in pregnancy is associated with prematurity and preeclampsia. Confirmation of the SLE diagnosis based on anamnesis, physical examination, and laboratory results is essential to differ the similar symptoms of normal pregnancy from pregnancy with SLE, such as preeclampsia, to lupus nephritis due to differences in treatment. The management of SLE in pregnancy has begun to be well understood; therefore, immunosuppressive drugs can be administered according to the indications and fetal safety. It is essential to educate women with SLE to not get pregnant before the 6-months remission period and explain the relative contraindications to pregnancy.Keywords: systemic lupus erythematosus; pregnancy; immunosuppressive Abstrak: Lupus eritematosus sistemik (LES) merupakan suatu penyakit autoimun multi-organ yang dapat menyerang wanita usia reproduktif. Kehamilan menyebabkan perubahan pada sistem imun dan neuroendokrin. LES pada wanita hamil dihubungkan dengan kejadian kelahiran prematuritas dan preeklamsia. Penentuan diagnosis berdasarkan anamnesis, pemeriksaan fisik, dan pemeriksaan penunjang penting untuk membedakan gejala-gejala yang mirip pada kehamilan normal dengan kehamilan yang disertai LES seperti preeklamsia dengan lupus nefritis karena tatalaksana yang diberikan berbeda. Tatalaksana LES pada kehamilan telah mulai dipahami sehingga pemberian obat-obatan imunosupresif dapat diberikan sesuai dengan indikasi dan keamanan pada janin. Penting untuk mengedukasi wanita dengan LES untuk tidak hamil sebelum melewati masa remisi enam bulan dan menjelaskan kontraindikasi relatif pada kehamilan.Kata kunci: lupus eritematous sistemik; kehamilan; imunosupresif

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Pregnancy in Women With Systemic Lupus and Lupus Nephritis

Cited by 24 publications

References 58 publications

Pregnancy Outcomes in Systemic Lupus Erythematosus Women

Pregnancy Outcomes in Systemic Lupus Erythematosus Women

Abordagem do lúpus eritematoso sistêmico em gestantes: revisão narrativa

Lupus Eritematosus Sistemik (LES) pada Kehamilan

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