SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)-PREGNANCY

SUMMARY

1. Pregnancy is not advised until disease has been quiescent for 6 months or longer.

2. Risk of pregnancy complications (flares or fetal problems) is much greater if disease is active (especially renal manifestations) or if the mother has anti-dsDNA or antiphospholipid antibodies.

3. Women with anti-phospholipid syndrome (APS) and a history of recurrent miscarriages can be treated with heparins (LMWH/unfractionated) & low-dose aspirin to decrease the incidence of miscarriage.

4. Patients with APS antibodies are also at increased risk for HELLP syndrome (a variant of preeclampsia with hemolysis, elevated liver enzymes, and low platelets).

5. In mothers with SLE who have SSA (Ro) and SSB (La) antibodies, fetal heart block can occur.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].