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The Clinical Analysis of 61 Pregnancies with Systemic Lupus Erythematosus
Ran-ran DENG
2017, 44 (1):
95-98.
Objective: To explore the systemic lupus erythematosus with respect to obstetric complications, pregnant outcomes and the manner of delivery. Methods: we reviewed the medical records of SLE pregnant women treated from January 1, 2010 to December 31, 2015 in Tianjin medical university general hospital. According to clinical manifestation, laboratory examination, drug treatment during pregnancy, the patients is divided into the stability of SLE group (35 cases) and SLE activity group (26cases). Results: In terms of pregnancy complications, the incidence of preeclampsia in SLE disease activity group was obviously higher than that in the stability of SLE group(58% vs 0,P=0.000). The incidence of other complications of premature rupture of membranes, fetal distress, fetal intrauterine growth restriction, postpartum hemorrhage, and oligohydramnios has no statistically significant difference between two groups (P > 0.05). In expect of pregnant outcomes and the manner of delivery, the incidence of prematurity(50% vs 20%,P=0.014),low birth weight infant(50% vs 20%,P=0.014), therapeutic abortion(27% vs 3%,P=0.018)in SLE disease activity group was obviously higher than that in the stability of SLE group. However, there has no statistically significant difference between low birth weight infant with preterm birth and low birth weight infant with term birth. The incidence of stillbirth, spontaneous, embryonic development stopping, Neonatal lupus, and cesarean delivery has no statistically significant difference between two groups (P > 0.05). Two patients from four patients with SLE found in pregnancy were diagnosed with lupus in the department of rheumatology clinic due to repeated fetal heart rate fluctuation between 115 ~ 125bpm. Conclusions: Preganat women with SLE are high-risk patients. The incidence of preeclampsia, prematurity, low birth weight infant, therapeutic abortion is high in SLE activity. Pregnancy should be planned after remission for more than six months. Clinical manifestations, blood pressure, and laboratory examination, such as urinary protein, kidney function, immunological indexes, should be closely monitoring during pregnancy. So, we can find SLE disease activity timely and timely treatment in order to reduce the incidence of pregnancy complications and adverse outcomes. It is worth noting that preeclampsia occuring during pregnancy should be be distinguished with lupus and for repeated low heart rate of maternal pregnancy, should also be alert to merge lupus and the repeated slow fetal heart rate during pregnancy should be alert to the lupus.
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