John D. Chovan, James R. Cacchillo
Systemic Lupus Erythematosus, Pregnancy
Immune System Diseases | Medical Pathology | Medicine and Health Sciences | Nursing
Systemic lupus erythematosus (SLE) is a life-long, life-threatening autoimmune disease which can affect any organ in the body (Marks & Tullus, 2011). SLE disproportionately affects women in a ratio of 9:1 compared to men with most women being affected during child-bearing age (15-50 years) (Ferenkeh-Koroma, 2012). Pregnancy represents a challenge for the patient with SLE. Pregnant patients with SLE are considered high-risk for multiple medical and obstetric complications, as flares are related to increased irreversible organ damage (Ateka- Barrutia & Khamashta, 2013). Severe flares are also associated with poor fetal outcomes (Peart & Clowse, 2014). Successful pregnancies happen in 67% of women with lupus compared to 85% in the general population (Ferenkeh-Koroma, 2012). There is a 20-fold risk in maternal mortality and an increased rate of hypertension, pre-gestational diabetes, renal impairment, pulmonary hypertension, major infections, thrombotic events, and other hematological complications in patients with lupus (Ateka- Barrutia & Khamashta, 2013). There is a higher risk for preterm labor in patients with lupus with 25% of pregnancies resulting in delivery before 37 weeks gestation (Ferenkeh-Koroma, 2012). There is also a greater risk for pre-eclampsia, intrauterine growth restriction (IUGR) and cesarean section (Ateka-Barrutia & Khamashta, 2013).
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