Central nervous system lupus and pregnancy: 11-year experience at a single center.
OBJECTIVE
To describe the pregnancy outcomes in women with central nervous system (CNS) manifestations of lupus.


METHODS
Between 1991 and 2002, the outcome of five pregnancies in four patients with CNS lupus were retrospectively reviewed. All patients had an established history of systemic lupus erythematosus (SLE), and either a history of CNS lupus or active CNS lupus. Pregnancy outcomes assessed included term and preterm birth, intrauterine growth restriction, abnormal antepartum testing, perinatal mortality, pre-eclampsia and other maternal morbidities.


RESULTS
Evidence of active CNS lupus symptoms developed in three of the five pregnancies. Two pregnancies were complicated by early onset pre-eclampsia, abnormal antepartum testing and extreme prematurity, with one subsequent neonatal death. The remaining three pregnancies had good neonatal outcomes, but were complicated by severe maternal post-pregnancy exacerbations, and the eventual death of one patient.


CONCLUSIONS
CNS lupus in pregnancy represents an especially severe manifestation of SLE, and may involve great maternal and fetal risks.
El-Sayed
Y Y
YY
Department of Gynecology and Obstetrics, Stanford University Medical Center, California 94305, USA.
Lu
E J
EJ
Genovese
M C
MC
Lambert
R E
RE
Chitkara
U
U
Druzin
M L
ML
D000328:Adult; D002140:California; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D020945:Lupus Vasculitis, Central Nervous System / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D011256:Pregnancy Outcome; D011295:Prenatal Care; D011296:Prenatal Diagnosis; D012189:Retrospective Studies