Pregnancy in patients with systemic lupus erythematosus

The view that SLE in pregnancy is associated with poor maternal and perinatal outcome is generally accepted. Consequently, there is a mistaken but commonly held belief that termination of such pregnancies will safeguard maternal health. However, because of advances in diagnostic technology, improved antenatal and neonatal surveillance, wider treatment options and a clearer understanding of the pathological processes involved, such a view is no longer tenable. This article outlines the changes in obstetric practice that have made pregnancy in women with SLE a relatively safe process. In particular, it emphasizes the need for a multidisciplinary approach to caring for such pregnancies. It also draws out some of the experiences we have had with the management of such pregnancies in Singapore that will reinforce the view that women with SLE can reproduce safely and successfully given appropriate care.