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Retrospective analysis of pregnancy outcomes complicated by systemic lupus erythematosus at a rural tertiary care center in Kerala, India
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Jaimie T Jacob *    , S Lakshmi Vinodh , Nisha V , Anamika Francis |
| Department of obstetrics & Gynecology, Government Medical College, Trivandrum, Kerala, India , jaimie.jacob@gmail.com |
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Abstract: (919 Views) |
Background: Systemic lupus erythematosus (SLE) affects women of childbearing age, leading to higher maternal and fetal morbidity and mortality. Disease flares during pregnancy complicate care. This study evaluates maternal and fetal outcomes in pregnancies complicated by SLE.
Methods: A retrospective analysis was conducted on 31 pregnancies complicated by SLE at the Department of Obstetrics and Gynaecology, TD Medical College, Alleppey, from January 2010 to December 2018. Data on maternal demographics, obstetric history, SLE manifestations, treatments, pregnancy outcomes, complications, disease flares, interventions, and delivery details were collected. Maternal complications, including gestational hypertension, pre-eclampsia/eclampsia, HELLP syndrome, diabetes, abruption, preterm birth, fetal growth restriction, lupus nephritis, and postpartum hemorrhage, were examined. Fetal outcomes were assessed based on perinatal morbidity and mortality and NICU admissions.
Results: Among the 31 pregnancies, 67% of the women were aged 20-30 years. SLE was diagnosed during the current pregnancy in 45.2% of cases, with 53.3% of these diagnoses occurring in the first trimester. Preterm birth was the most common complication, observed in 48.4% of pregnancies, with 29% live born and 19.4% stillborn. Hypertensive disorders were prevalent, with 38.7% developing pre-eclampsia/eclampsia. Antiphospholipid antibody positivity was noted in 29% of patients. Severe SLE flares occurred in 12.9% of patients, all with nephropathy in the third trimester.
Conclusion: Favorable pregnancy outcomes are more likely in women whose SLE activity is quiescent for at least six months before conception, without lupus nephritis, antiphospholipid syndrome, or superimposed preeclampsia. The findings emphasize the need for vigilant monitoring and management of pregnancies complicated by SLE.
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| Keywords: Female, Lupus Erythematosus, Systemic, Pregnancy, Pregnancy Complications, Pregnancy Outcome |
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Full-Text [PDF 309 kb]
(133 Downloads)
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Type of Study: Original Research |
Subject:
Reproductive Health
Received: 2024/06/1 | Accepted: 2024/06/28 | Published: 2024/06/30
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