[Development of the pregnancy and labor in patient with systemic lupus erythematosus]

Pregnancy and its outcome in a woman with systemic lupus erythematosus.

Case report.

Obstetrics and Gynecology Department, Charles University, 2nd Medical Faculty and Faculty Hospital Motol, Prague, Cardiocentrum, University Hospital Motol, Prague.

Patient with systemic lupus erythematosus (SLE) was admitted to our department at 31 weeks of gestation with diagnosed fetal bradycardia. Detailed prenatal echocardiography revealed complete atrioventricular block (AVB III) with atrial rate of 140 b.p.m. and ventricular rate of 70 b.p.m., fetoplacental failure was not present at initial examination. Patient was hospitalised for the remainder of the pregnancy, which continued to full-term without complications. During delivery, fetal pulse oxymetry was utilized to monitor fetal state saturation levels. Labour proceeded without complications with an Apgar score of 9-9-9. The newborn was observed at the ICU and the Cardiac center and deemed to be in stable condition with AVB III without any signs of heart failure and without the necessity for pacemaker implantation.

In cases of diagnosed fetal bradycardia, it is beneficial to expand the methods of fetal monitoring during labour. Pre-, peri-, and postnatal observation of pregnant women diagnosed with SLE and fetal bradycardia should be done in specialised facilities that are able to provide the appropriate level of care for mother and infant.