Systemic lupus erythematosus and pregnancy

Grammatikakis J, Salamalekis G, Evagelinakis N, Patsouras K, Kassanos D

3rd Department of Obstetrics and Gynecology, University of Athens, Attikon hospital, Athens, Greece

Correspondence: Grammatikakis J,3rd Department of Obstetrics and Gynecology, University of Athens, Attiko hospital, 1 Rimini St, GR-12464 Athens, Greece

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Abstract

Women with systemic lupus erythematosus (SLE) face significant risks in pregnancy. Pregnancy in SLE should be planned and a management strategy should be agreed with the patient, prior to conception. Pregnancy increases the likelihood of a lupus flare. Unfortunately, it is not possible to predict when, or if, an individual patient will flare,  although flare is more likely if disease had been active within 6 months prior conception. Worsening of proteinuria in pregnancy could herald a lupus flare, but the differential diagnosis also includes the physiological response to pregnancy and pre-eclampsia. Corticosteroids, hydroxychloroquine and azathioprine are safe to use in pregnancy. Correct identification of patients with antiphospholipid syndrome is important because treatment of affected women during pregnancy can improve fetal and maternal outcome.
 

Key words: systemic lupus erythematosus; obstetric outcome; antiphospholipid syndrome