A series of 6 cases of systemic lupus erythematosus in pregnancy

Abstract

Background: Systemic lupus erythematosus (SLE) is a type of chronic inflammatory connective tissue disease commonly diagnosed between the ages of 20-30 It is more common in women than in men, especially during the fertile period of a women’s life. In olden days pregnancy in patients with SLE were discouraged due to concern regarding the poor feto-maternal outcomes. However, over the last 10-15 years, medical practice has changed, and in many cases pregnancy is possible with close supervision, and advice tailored according to individual cases. This case series will explain what care need to be taken into consideration prior to conception, ANC period and post pregnancy 100.

Methods: This was a retrospective study conducted at Seth G. S. M. C. and KEM Hospital Parel after IEC approval where 6 cases of Systemic Lupus Erythematosus in pregnancy over a period of 1 year in a unit were collected and are presented here with regards to maternal and fetal outcomes.

Results: In our case series two patients required Caesarean section for fetal indication and both the babies had congenital heart block and were asked regular follow up in cardiology outpatient department, two patients required medical termination of pregnancy in view of teratogenic drug exposure(cyclophosphamide), one patient had intrauterine growth restriction and had a preterm vaginal delivery with good fetal outcome and no heart block in the baby and the last patient was diagnosed as a case of SLE when baby was found to have heart block in the antenatal period and was later evaluated and diagnosed as a case of SLE.

Conclusions: Lupus activity is increased in pregnancy and patients with SLE are at higher risk for spontaneous abortions, fetal death, PIH, preterm delivery and intrauterine growth retardation. Management of these cases requires a multidisciplinary approach involving the obstetrician, rheumatologist, nephrologist and neonatologist.