Systemic lupus erythematosus and pregnancy

Abstract

Systemic lupus erythematosus and pregnancy

Sujirote    Hanthavichai    MD

Department of Medicine, BMA Medical College and Vajira Hospital

SLE is the most common autoimmune disease in childbearing age women. SLE patients are as fertile as normal women, their pregnancy associated with complications such as pre-eclampsia, premature labor, fetal loss and intrauterine growth retardation. In addition, there is chance for flaring of SLE during pregnancy which has relation with activity before pregnancy or at conception. SLE patients should be in remission and should not be on immunosuppressive agents for at least 6 months prior to pregnancy. Mothers should be assessed for activity and fetus should be monitored at least every month after the first trimester and until postpartum period including fetal monitoring. Treatment of active disease should be considered and weighed between benefits and adverse effects. Corticosteroid hydroxychloroquine and NSAID are recommened and generally safe but should be closely monitored. Cytoxic agents is not used if there is no severe exacerbation and in such case azathioprine is preferred

Vajira Med J 2004 ; 48 : 33 - 39