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09:43
Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
Published on: June 8, 2022
[Pregnancy and systemic lupus erythematosus].
D Lê Thi Huong1, B Wechsler, J-C Piette
1Service de médecine interne, hôpital Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, université Pierre-et-Marie-Curie Paris-6, 47-83, boulevard de l'Hôpital, 75634 Paris cedex 13, France. du.boutin@psl.aphp.fr
La Revue De Medecine Interne
|August 12, 2008
Summary
Pregnancy is generally safe for women with systemic lupus erythematosus (SLE). Careful monitoring and management of SLE activity, antiphospholipid antibodies (aPL), and therapies are crucial for successful pregnancy outcomes.
Area of Science:
- Reproductive immunology
- Rheumatology
- Maternal-fetal medicine
Context:
- Systemic lupus erythematosus (SLE) presents unique challenges during pregnancy.
- Fertility in SLE patients is comparable to the general population, but sterility can occur due to autoimmune factors or antiphospholipid antibodies (aPL).
- Cyclophosphamide use is a significant contributor to sterility, potentially preventable with acetate leuprolide.
Purpose:
- To review the current understanding of pregnancy in women with SLE.
- To outline factors influencing maternal, fetal, and neonatal morbidity.
- To discuss established monitoring and therapeutic strategies for SLE pregnancies.
Summary:
- Pregnancy is authorized in SLE, but risks include sterility (due to autoimmune ovaritis, aPL, or cyclophosphamide), maternal morbidity (linked to SLE activity, hypertension, preeclampsia, HELLP syndrome, therapy, and aPL), and fetal/neonatal morbidity (related to prematurity, maternal steroid therapy, and anti-SSA antibodies).
- Antiphospholipid antibodies (aPL) contribute to thrombosis and implantation issues.
- Hydroxychloroquine (HCQ) is recommended throughout pregnancy; aspirin and heparin are used based on aPL status and history.
- Doppler ultrasonography is vital for predicting pregnancy outcomes, with abnormal findings indicating increased risk.
Impact:
- Established guidelines for SLE pregnancy management improve outcomes.
- Understanding risk factors allows for proactive monitoring and intervention.
- Further research may refine preventive strategies for sterility and fetal complications.
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