Pregnancy‐related issues in women with systemic lupus erythematosus
Identifieur interne : 000F30 ( Main/Exploration ); précédent : 000F29; suivant : 000F31Pregnancy‐related issues in women with systemic lupus erythematosus
Auteurs : Abha G. Singh [États-Unis] ; Vaidehi R. Chowdhary [États-Unis]Source :
- International Journal of Rheumatic Diseases [ 1756-1841 ] ; 2015-02.
Abstract
While fertility is preserved in females with systemic lupus erythematosus (SLE), it is well established that pregnancy in these patients is associated with adverse maternal and fetal outcomes, including pregnancy loss, pre‐eclampsia, preterm delivery and intrauterine growth retardation, as well as neonatal mortality. Mechanisms underlying these adverse outcomes are poorly understood, and better understanding of these would allow development of targeted and personalized treatment strategies. Established risk factors for adverse pregnancy outcomes include active disease within 6 months prior to conception and during pregnancy, active nephritis, maternal hypertension, antiphospholipid antibodies and hypocomplementemia. While intensive monitoring is recommended, the comparative effectiveness of appropriate management strategies is unclear. While current strategies are able to achieve live births in 85–90% of pregnancies, certain aspects such as prevention of preterm birth, treatment of congenital heart block due to neonatal lupus and recurrent pregnancy loss despite best management, remains challenging. Pregnancy is also associated with an increased risk of flare of lupus, particularly in patients with active disease at time of conception or within 6 months prior to conception. Pregnant patients with SLE should be followed in a high‐risk obstetric clinic, and care should be closely coordinated between the obstetrician and rheumatologist.
Url:
DOI: 10.1111/1756-185X.12524
Affiliations:
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Singh</name><affiliation wicri:level="1"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Minnesota, Rochester</wicri:regionArea><wicri:noRegion>Rochester</wicri:noRegion></affiliation></author><author><name sortKey="Chowdhary, Vaidehi R" sort="Chowdhary, Vaidehi R" uniqKey="Chowdhary V" first="Vaidehi R." last="Chowdhary">Vaidehi R. 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Mechanisms underlying these adverse outcomes are poorly understood, and better understanding of these would allow development of targeted and personalized treatment strategies. Established risk factors for adverse pregnancy outcomes include active disease within 6 months prior to conception and during pregnancy, active nephritis, maternal hypertension, antiphospholipid antibodies and hypocomplementemia. While intensive monitoring is recommended, the comparative effectiveness of appropriate management strategies is unclear. While current strategies are able to achieve live births in 85–90% of pregnancies, certain aspects such as prevention of preterm birth, treatment of congenital heart block due to neonatal lupus and recurrent pregnancy loss despite best management, remains challenging. Pregnancy is also associated with an increased risk of flare of lupus, particularly in patients with active disease at time of conception or within 6 months prior to conception. Pregnant patients with SLE should be followed in a high‐risk obstetric clinic, and care should be closely coordinated between the obstetrician and rheumatologist.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country></list><tree><country name="États-Unis"><noRegion><name sortKey="Singh, Abha G" sort="Singh, Abha G" uniqKey="Singh A" first="Abha G." last="Singh">Abha G. Singh</name></noRegion><name sortKey="Chowdhary, Vaidehi R" sort="Chowdhary, Vaidehi R" uniqKey="Chowdhary V" first="Vaidehi R." last="Chowdhary">Vaidehi R. Chowdhary</name><name sortKey="Chowdhary, Vaidehi R" sort="Chowdhary, Vaidehi R" uniqKey="Chowdhary V" first="Vaidehi R." last="Chowdhary">Vaidehi R. Chowdhary</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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