Lupus and pregnancy: integrating clues from the bench and bedside
Identifieur interne : 001545 ( Main/Exploration ); précédent : 001544; suivant : 001546Lupus and pregnancy: integrating clues from the bench and bedside
Auteurs : Guillermo Ruiz-Irastorza [Espagne] ; Munther A. Khamashta [Royaume-Uni]Source :
- European Journal of Clinical Investigation [ 0014-2972 ] ; 2011-06.
English descriptors
- Teeft :
- Active disease, Adverse pregnancy outcomes, Antiphospholipid, Antiphospholipid syndrome, Arthritis rheum, Aspirin, Clinical investigation, Complication, Congenital, Congenital heart block, Disease activity, Doppler, Erythematosus, European journal, Foetal, Foetal death, Foetal distress, Heparin, High risk, Higher risk, Hydroxychloroquine, Hypertension, Immunosuppressive drugs, Khamashta, Lupus, Lupus activity, Lupus nephritis, Lupus research unit, Miscarriage, Nephritis, Other hand, Perinatal death, Placental, Preeclampsia, Pregnancy, Pregnancy complications, Pregnancy outcome, Pregnant women, Prematurity, Previous thrombosis, Prospective study, Proteinuria, Rayne institute, Recent study, Renal, Renal disease, Renal failure, Rheum, Rheumatol, Stichting european society, Syndrome, Systematic review, Systemic, Systemic lupus erythematosus, Thrombosis.
Abstract
Eur J Clin Invest 2011; 41 (6): 672–678 Abstract: Adequate pregnancy care of women with systemic lupus erythematosus (SLE) rests on three pillars: a coordinated medical‐obstetrical care, an agreed and well‐defined management protocol and a good neonatal unit. Pregnancy should be planned following a preconceptional visit for counselling. Women with severe active disease or a high degree of irreversible damage, such as those with symptomatic pulmonary hypertension, heart failure, severe restrictive pulmonary disease or severe chronic renal failure should best avoid pregnancy. Treatment is based on hydroxychloroquine, low‐dose steroids and azathioprine. Patients with antiphospholipid antibodies/syndrome should receive low‐dose aspirin +/− low molecular weight heparin. The addition and the dose of heparin depend on the clinical profile of the patient, i.e. a previous history of miscarriage, foetal loss, placental insufficiency or thrombosis. A close surveillance, with monitoring of blood pressure, proteinuria and placental blood flow by Doppler studies helps the early diagnosis and treatment of complications such as preeclampsia and foetal distress. Postpartum follow‐up is important.
Url:
DOI: 10.1111/j.1365-2362.2010.02443.x
Affiliations:
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Pregnancy should be planned following a preconceptional visit for counselling. Women with severe active disease or a high degree of irreversible damage, such as those with symptomatic pulmonary hypertension, heart failure, severe restrictive pulmonary disease or severe chronic renal failure should best avoid pregnancy. Treatment is based on hydroxychloroquine, low‐dose steroids and azathioprine. Patients with antiphospholipid antibodies/syndrome should receive low‐dose aspirin +/− low molecular weight heparin. The addition and the dose of heparin depend on the clinical profile of the patient, i.e. a previous history of miscarriage, foetal loss, placental insufficiency or thrombosis. A close surveillance, with monitoring of blood pressure, proteinuria and placental blood flow by Doppler studies helps the early diagnosis and treatment of complications such as preeclampsia and foetal distress. 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