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Nursing management for nephrotic syndrome adapts as the disease progresses, with strategies evolving to address advancing symptoms and complications.Early-Stage Management In the early stages, nursing interventions for nephrotic syndrome resemble those used in managing acute glomerulonephritis, focusing on symptom monitoring, fluid balance, and managing mild to moderate edema.Vital Signs: Regularly monitor blood pressure, pulse, respiratory rate, and temperature to promptly identify...
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Managing lupus patients during pregnancy.

Aisha Lateef1, Michelle Petri

  • 1Division of Rheumatology, University Medicine Cluster, National University Health System, 1E, Kent Ridge, Singapore 119074, Singapore.

Best Practice & Research. Clinical Rheumatology
|November 19, 2013
PubMed
Summary

Systemic lupus erythematosus (SLE) pregnancy is high-risk, impacting maternal and fetal health. Optimal outcomes require multidisciplinary care and close monitoring for complications like flares and pre-eclampsia.

Keywords:
Anti-phospholipid antibodiesFoetal lossNeonatal lupus syndromesPre-eclampsiaPregnancySystemic lupus erythematosus

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Area of Science:

  • Rheumatology
  • Obstetrics
  • Immunology

Background:

  • Systemic lupus erythematosus (SLE) predominantly affects young females, posing significant risks during pregnancy.
  • Pregnancy in women with SLE is associated with increased maternal and fetal mortality and morbidity.

Purpose of the Study:

  • To review the challenges and management strategies for pregnancies in women with SLE.
  • To highlight key fetal and maternal complications and unresolved issues in SLE pregnancies.

Main Methods:

  • Literature review focusing on outcomes, complications, and management of SLE during pregnancy.
  • Analysis of maternal and fetal risks, diagnostic challenges, and treatment limitations.

Main Results:

  • High risks of fetal loss, preterm birth, intrauterine growth restriction (IUGR), and neonatal lupus syndromes (NLSs).
  • Maternal complications include disease flares, pre-eclampsia, and diagnostic confusion with lupus nephritis.
  • Limited safe medication options and unresolved issues like refractory pregnancy loss and fetal heart block.

Conclusions:

  • Pregnancy in SLE patients necessitates a multidisciplinary approach with close monitoring.
  • Effective management requires careful differentiation between physiological changes and disease activity.
  • Addressing specific complications like anti-phospholipid antibody-associated pregnancy loss and anti-Ro antibody-associated heart block remains critical.