Systemic lupus erythematosus and pregnancy.
Although most women with systemic lupus erythematosus can achieve a successful pregnancy, fetal (fetal loss, preterm birth) and maternal (lupus flares, worsening renal function) morbidity remain major problems. Predictors of fetal loss and preterm birth have been identified and are reviewed. Modern management of lupus pregnancy includes identification of high-risk pregnancies with appropriate monitoring and treatment (when indicated) for anti-Ro and antiphospholipid antibodies, frequent assessment of and control of maternal lupus activity, adjustment of medications to avoid those associated with fetal teratogenicity, and the appropriate use of fetal assessment tests to guide intervention for the fetus at risk of intrauterine death.
Petri
M
M
Division of Molecular and Clinical Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D017152:Antibodies, Antiphospholipid / Q000276:immunology; D000959:Antihypertensive Agents / Q000627:therapeutic use; D000962:Antimalarials / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000150:complications; D005260:Female; D005313:Fetal Death / Q000209:etiology; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007674:Kidney Diseases / Q000209:etiology; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy; D007752:Obstetric Labor, Premature / Q000209:etiology; D011225:Pre-Eclampsia / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000276:immunology*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D017152:Antibodies, Antiphospholipid; D000959:Antihypertensive Agents; D000962:Antimalarials; D005938:Glucocorticoids; D007166:Immunosuppressive Agents