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MR Vol.13 No.4 indexに戻る
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MODERN RHEUMATOLOGY
Vol.13 No.4 |
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An overview on systemic lupus erythematosus pregnancy |
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| Wei Zhang1 and Shun-le Chen1 |
| (1) Department of Rheumatology, Renji Hospital,
Shanghai Institute for Rheumatology, Shanghai Second Medical University,
Mid ShanDong Rd., 145, Shanghai, 200001, PR China |
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| Abstract |
| A systemic lupus erythematosus (SLE)
pregnancy is no longer regarded as unacceptable, with an early diagnosis,
a mild disease condition, and good interdisciplinary collaboration
ensuring intense surveillance of pregnant SLE patients. The key point
is a sufficiently long period of disease quiescence before conception.
A low dose of prednisone is preferable during pregnancy. Nevertheless,
20% of disease flare-up still happens interpartum or postpartum,
even in such well-planned pregnancies, although usually with only
mild severity. Pregnancy during an active disease stage, especially
active nephritis, should always be avoided. Substantial renal function
damage may occur, and there is a relatively high prevalence of preeclampsia,
which may further compromise the mother as well as the fetus. It
is well documented that antiphospholipid syndrome and antiphospholipid
antibodies are strongly associated with fetal wastage. Low-dose aspirin
or heparin is indicated for a favorable fetal outcome. Women with
positive anti-SSA and/or anti-SSB should be aware of the danger of
congenital heart block in their infants. Cytotoxic drugs applied
in the early stage of pregnancy are dangerous to the fetus. A rather
long-term follow-up is required to make a precise evaluation of the
maternal SLE influence on the offspring. |
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| Key words |
Fetus - Medication - Pregnancy -
Risk - Systemic lupus erythematosus (SLE)
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