Review article

Pregnancy in women with systemic lupus erythematosus

Felina Anić ; Odjel za reumatologiju i kliničku imunologiju, Klinika za internu medicinu, KBC Rijeka, Rijeka, Hrvatska
Srđan Novak ; Odjel za reumatologiju i kliničku imunologiju, Klinika za internu medicinu, KBC Rijeka, Rijeka, Hrvatska

Abstract

Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease. It primarily affects women in their reproductive years, making the issue of pregnancy important to doctors as a clinical and therapeutic problem. Due to the hormonal and immunological influence during pregnancy, an increase in disease activity can occur and manifest mostly as a musculoskeletal and cutaneous condition. Additionaly, women with SLE have a larger number of complicated pregnancies which can result in miscarriage, preterm birth, preeclampsia, cesearean section and low birth weight. Increased lupus activity, or presence of antiphospholipid antibodies significantly increases the risk for these comlications. Treatment of SLE in pregnancy represents a great challenge and the best prevention of lupus flare during pregnancy is to delay conception until the woman has had a period of quiescent disease for at least six months. Women who have mild SLE can be treated with low dose of prednisone. NSAIDs can be used during the latter part of the 1st trimester and during the 2nd trimester. If women develop lupus flare, they can be treated with higher doses of corticosteroids, including pulse steroid therapy. The antimalaric medications (especially hydroxychloroquine) may also be used during pregnancy to decrease the risk of SLE flare. Women with recurrent spontaneous abortion and antiphospholipid antibodies need to take aspirin and/or low molecular weight heparin. Careful planning, especially during remission, and appropriate treatment may be required to prevent possible complications that can happen during pregnancy.

Keywords

antiphospholipid sydrome; lupus activity; pregnancy; systemic lupus erythematosus

Hrčak ID:

80229

URI

https://hrcak.srce.hr/80229

Publication date:

1.3.2012.

Article data in other languages: croatian

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