Author(s): Menon Nalini Sekharan1, S. Lakshmi2
Pregnancy and child birth in SLE patients can be complicated by disease activity, lupus nephritis, gestational diabetes, hypertensive disorders, intrauterine growth retardation, placental abruption, intrauterine and neonatal death, birth asphyxia, neonatal lupus and maternal mortality.
AIMS AND OBJECTIVES: To find out 1) The most common complications and their incidence. 2) Maternal and fetal outcome in SLE patients during pregnancies. Study design; Prospective observational study.
MATERIALS AND METHODS: Patients are enrolled for the study from pregnant mothers with known as well as newly diagnosed SLE who are attending outpatient department of obstetrics and gynecology department of Institute of maternal and child health, Calicut Government Medical college from 2011 February to 2012 June (18 months). Data collected from available past medical records, interview, physical examination, progress records and laboratory investigations of patients using predesigned proforma.
RESULTS: Of the total 40 patients enrolled in the study, 45% were in the age group 26-30. 25% had one abortion in the past and 2 patients had 3 abortions. 65% had the disease for more than 6 years. Prior to the present pregnancy, 95% patients were in remission. During the present pregnancy 25 % patients had active lupus nephritis and 20% had flare. 25% and 75% patients had gestational diabetes mellitus and hypertensive disorders respectively. The incidence of intra uterine growth retardation was 45%. Placental abruption occurred in 10% pregnancies. The incidence of intrauterine death (25%) was higher than that of neonatal deaths (10%). 20% babies had birth asphyxia and the incidence of low birth weight was very high (60%). 10% mothers had flare and 10% babies neonatal lupus. Maternal mortality was 5%.
CONCLUSION: The study highlights the increased incidence of complications associated with pregnancies in SLE and thus the need for high quality care for better maternal and fetal outcome.