Successful Pregnancy Outcome in a Case of Systemic Lupus Erythematosus

2017 ◽  
Vol 9 (2) ◽  
pp. 134-136
Author(s):  
Leelavathi Basava ◽  
K Triveni ◽  
G Sindhu Sree
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Pregnancy Outcome ◽  
Lupus Erythematosus ◽  
Immunosuppressive Agents ◽  
Fetal Loss ◽  
Therapeutic Interventions ◽  
Elective Cesarean Section ◽  
Childbearing Age ◽  
Systemic Lupus ◽  
Successful Pregnancy

ABSTRACT Systemic lupus erythematosus (SLE) is an autoimmune disease most frequently found in women of childbearing age and may coexist with pregnancy. Disease exacerbation, increased fetal loss, neonatal lupus, and an increased incidence of preeclampsia are the major challenges. Its multisystem involvement and therapeutic interventions like anticoagulants, steroids, and immunosuppressive agents pose a high risk for both the mother and the fetus during the antenatal period as well as postpartum. Good multidisciplinary medical care is mandatory when detection or flare-up of SLE occurs during pregnancy. We describe the successful management of an antinuclear antibody, antiribonucleoprotein antibody, and anti-Sjogren's syndrome A (Ro) antibody positive parturient with bad obstetric history who underwent elective cesarean section and delivered a healthy child. How to cite this article Basava L, Roy P, Triveni K, Sree GS. Successful Pregnancy Outcome in a Case of Systemic Lupus Erythematosus. J South Asian Feder Obst Gynae 2017;9(2): 128-130.

Systemic Lupus Erythematosus and Related Disorders

2014 ◽  
pp. 257-270
Author(s):  
Bonnie L. Bermas
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Central Nervous System ◽  
Nervous System ◽  
Lupus Erythematosus ◽  
Immunosuppressive Agents ◽  
Future Research ◽  
High Dose ◽  
Childbearing Age ◽  
Systemic Lupus ◽  
Multisystem Disease

Systemic lupus erythematosus (SLE) is a multisystem disease that preferentially affects women of childbearing age. This disorder is both more common and more severe in individuals of African and Asian ancestry. The etiology of SLE is not well understood, although genetics and environmental stimuli clearly are involved. Whether this disease is caused by a T-cell, B-cell, or other immunologic malfunction is debated, but all would agree that clearly autoantibodies such as antinuclear antibodies and anti–double-stranded DNA contribute to the pathophysiology of this disorder. This multisystem disease can affect the skin, joints, lungs, heart, kidneys, and central nervous system. Most of the morbidity and mortality is from renal and central nervous system (CNS) involvement, although accelerated atherosclerosis has recently been appreciated as a major contributor to disease burden. The treatment of SLE has improved over the past decade with less reliance on high-dose corticosteroids and more emphasis on immunosuppressive agents. It is our hope that future research into the pathophysiology of this disorder and the development of more specific therapy, such as biologics, will improve the outcome of this disease.

scholarly journals Live birth pregnancy outcome after first in vitro fertilization treatment in a patient with Systemic Lupus Erythematosus and isolated high positive IgA anti-β2glycoprotein I antibodies: a case report

Open Medicine ◽  
2017 ◽  
Vol 12 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Hristina Andreeva ◽  
Marit Seip ◽  
Stanislava Koycheva
Keyword(s):  
Systemic Lupus Erythematosus ◽  
In Vitro Fertilization ◽  
Pregnancy Outcome ◽  
Live Birth ◽  
Lupus Erythematosus ◽  
Fetal Loss ◽  
Systemic Lupus ◽  
Clinical Value ◽  
Vitro Fertilization

AbstractIgA anti-β2glycoprotein I antibodies (IgA-anti-β2GPI) seems to be the most prevalent isotype in patients with Systemic Lupus Erythematosus (SLE) with a significant association to thrombotic events. Both SLE and antiphospholipid syndrome (APS) can be associated with implantation failure, fetal loss and obstetric complications. Recent reports highlight the clinical value of IgA-anti-β2GPI determination in supporting in vitro fertilization (IVF) treatment and IVF pregnancy outcomes. We report a 36-year-old female diagnosed with SLE, endometriosis and unexplained infertility. Conventional APS markers were consistently negative: anti-cardiolipin (aCL) and anti-β2GPI: IgG/IgM. She was then tested with reports of repeatedly high IgA-anti-β2GPI and tested positive from 2014 after IgA (aCL; anti-β2GPI) were established in our APS diagnostic panel. She underwent successful first IVF procedure with a 30 week live birth pregnancy outcome. During the follow up no lupus flare, thrombosis or ovarian hyperstimulation syndrome were registered. Serum IgA anti-β2GPI and anti-dsDNA levels declined statistically significant during the second and third trimester. Titres of IgA-anti-β2GPI remained lower postpartum as well. This case highlights the clinical importance of IgA-anti-β2GPI testing for family planning, assisted reproduction and pregnancy in women with SLE and/or APS.

Pregnancy Outcomes in A Group Egyptian Patients with Systemic Lupus Erythematosus: A Cohort Study

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
DF Mohammed ◽  
HE Mansour ◽  
AE El-Feky ◽  
SM Hosny ◽  
CS Morad ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Cohort Study ◽  
Lupus Erythematosus ◽  
Pregnancy Outcomes ◽  
Fetal Loss ◽  
University Hospital ◽  
Intrauterine Fetal Death ◽  
Control Group ◽  
Childbearing Age ◽  
Systemic Lupus

Abstract Background Systemic lupus erythematosus (SLE) predominantly affects women of childbearing age thus pregnancy in lupus patients is a common clinical scenario. SLE adversely affects pregnancy outcomes and pregnancy leads to SLE flares Aim of the work Determining the frequencies and predictors of maternal and fetal pregnancy outcomes in women with SLE by a prospective cohort study Patients and methods seventy-one pregnant lupus patients were followed prospectively, and their data compared to age-matched pregnant healthy controls attending Ain Shams University Hospital clinics Results Thirteen Patients had activity at conception. Sixty-six(93%) Where on treatment. Flares occurred in 51 patients (72%) during pregnancy with nephritis being the most common occurring in 78%. The prevalence of anemia, AKI and hypertension (HTN) during pregnancy were higher in SLE group than control group (P < 0.01). The rate of delivery by Cesarean section (CS), PTL, postpartum hemorrhage, preeclampsia (PE), severe PE and HELLP were higher in SLE group then control group (P < 0.01) as well as an increase in rate of postpartum infection (P < 0.05). There was an increase in rate of fetal loss, prematurity, intrauterine growth restriction (IUGR), NICU admission, still birth/intrauterine fetal death and highly significant decrease in fetal weight in SLE group than control group (P < 0.01). Pregestational HTN was independently associated with PE (OR 91.228; CI 6.791-1225.538). Proteinuria and HTN during pregnancy were independently associated with prematurity (OR 14.162 CI 1.029-194.958 & OR 10.596, CI 1.460-76.894). Conclusion Pregnancy in lupus patients carries a higher risk of pregnancy morbidity and worse fetal outcomes than the controls.

scholarly journals Incidence and prevalence of systemic lupus erythematosus among Korean women in childbearing years: A nationwide population-based study

Lupus ◽  
2021 ◽  
pp. 096120332098484
Author(s):  
Min Kyung Chung ◽  
Jin Su Park ◽  
Hyunsun Lim ◽  
Chan Hee Lee ◽  
Jisoo Lee
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Health Information ◽  
National Health ◽  
Lupus Erythematosus ◽  
Health Resources ◽  
Population Group ◽  
Korean Women ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Systemic Lupus

Background Most women with systemic lupus erythematosus (SLE) are diagnosed with the disease in their reproductive years, but the incidence and prevalence of SLE among women of childbearing age have not been studied. The objective of this study was to estimate the incidence and prevalence of SLE among the Korean women of childbearing age. Methods Women aged 20 to 44 years with SLE were identified from National Health Insurance Service – National Health Information Database (2009-2016), which contain health information of approximately 97% of the Korean population. SLE was defined by International Classification of Diseases, 10th revision code, M32. Incidence and prevalence were calculated per 100,000 person-years and stratified by year and age. Results A total of 12,756 women with SLE were identified. The incidence of SLE from 2011 to 2016 among women in childbearing years was 8.18/100,000 person-years (95% CI 7.94–8.43), with the highest incidence in 2016 (8.56/100,000 person-years, 95% CI 7.95–9.17) and the lowest incidence in 2012 (7.85/100,000 person-years, 95% CI 7.28–8.42). The prevalence of SLE from 2009 to 2016 among women in childbearing years was 77.07/100,000 person-years (95% CI 75.76–78.39), with the highest prevalence in 2014 (79.47/100,000 person-years, 95% CI 77.64–81.30) and the lowest in 2010 (74.19/100,000 person-years, 95% CI 72.45–75.93). The peak age for SLE incidence was between 25–39 years, and lower incidence was seen in the early (20–24 years) and late (40–44 years) childbearing age periods. There was an increasing trend in prevalence according to age in women of childbearing age, with the highest prevalence occurring in the 40–44 age group. Conclusions The risk and burden of SLE are high among women during their childbearing years. This calls for special attention to this particular population group when allocating health resources.

Childhood-Onset Systemic Lupus Erythematosus: Antiphospholipid Antibodies in 37 Patients and Their First-Degree Relatives

PEDIATRICS ◽  
1993 ◽  
Vol 92 (6) ◽  
pp. 849-853
Author(s):  
Charles Molta ◽  
Olivier Meyer ◽  
Christine Dosquet ◽  
Marcela Montes de Oca ◽  
Marie-Claude Babron ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Antiphospholipid Antibodies ◽  
Clinical Manifestations ◽  
Fetal Loss ◽  
Childhood Onset ◽  
Systemic Lupus ◽  
First Degree Relatives ◽  
Antiphosphatidylethanolamine Antibodies ◽  
Onset Systemic Lupus Erythematosus

Objective. Antiphospholipid antibodies (aPL) are noted with increased frequency in patients with systemic lupus erythematosus (SLE). The main manifestations found to be associated with aPL are arterial and venous thrombotic events, thrombocytopenia, and recurrent pregnancy loss This study is an attempt to define the incidence of aPL in patients with childhood-onset SLE and in their relatives and to correlate their presence with clinical manifestations, and especially, to evaluate the risk of thrombosis in aPL-positive subjects. Methodology. We studied 37 unrelated patients and 107 of their first-degree relatives. VDRL, IgG and IgM anticardiolipin, and IgG antiphosphatidylethanolamine antibodies were studied in all probands during periods of clinical remission and in first-degree relatives at the time of interview. Lupus anticoagulant had only been studied in probands during an SLE flare-up. Results. Thirty-eight percent of probands and 19% of relatives were positive for at least one aPL, with little over-lap between the different aPL studied. -No aPL-negative proband developed thrombosis. Two of the aPL-positive probands had thrombotic events before testing, and a third one showed thrombosis after testing. Only two probands had high levels of IgG aCL and showed thrombosis. The occurrence of aPL positivity in relatives was not always related to its presence in probands. None of the aPL-positive relatives had hadthrombosis, but recurrent fetal loss was noted in one aPL-positive mother with SLE. Although there was a high frequency of SLE, SLE-like disease, auto-immune disorders or positive serological findings for lupus in first-degree relatives, many of these relativew did not test positive for aPL. Conclusion. The high levels of IgG aCL may be considered a risk factor for thrombosis. Findings in relatives suggest a multifactorial origin for autoimmune disease and antibody production.

Competence of medical and obstetric registrars in the management of systemic lupus erythematosus in pregnancy

2020 ◽  
pp. 1753495X2096467
Author(s):  
Jarrod Zamparini ◽  
Stuart Pattinson ◽  
Kavita Makan
Keyword(s):  
South Africa ◽  
Systemic Lupus Erythematosus ◽  
Pregnant Women ◽  
Lupus Erythematosus ◽  
Pass Rate ◽  
Childbearing Age ◽  
Systemic Lupus ◽  
Significant Difference ◽  
General Physicians ◽  
In Pregnancy

Introduction Systemic lupus erythematosus has a predilection for women of childbearing age. Globally a shortage of rheumatologists exists resulting in general physicians and obstetricians treating systemic lupus erythematosus in pregnancy. Methods We conducted a survey amongst medical and obstetric registrars in South Africa to assess their subjective and objective competence in managing pregnant women with systemic lupus erythematosus. Results The pass rate for the objective section was 70.8% with no statistically significant difference in the pass rate between medical and obstetric registrars. Participants felt unprepared to manage pregnant women with systemic lupus erythematosus, with a mean overall score of 3.4 out of 7 for the subjective section, based on four Likert scale type questions. Conclusion Trainees are not able to accurately assess their own levels of competence in order to identify their learning needs. Due to the shortage of rheumatologists and lack of obstetric physicians in South Africa, general physicians and obstetricians must be equipped to provide adequate care to pregnant women with systemic lupus erythematosus.

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