Problems associated with the management of pregnancies in patients with systemic lupus erythematosus

Eighty-three percent of 24 pregnancies in patients with systemic lupus erythematosus studied retrospectively terminated in normal children. Fifty-four percent of patients had clinical and serological disease exacerbations during pregnancy or in the post-partum period, as contrasted with 4% in the 6 months prior to pregnancy. The presence of significant renal disease and SLE activity in the 6 months prior to pregnancy correlated with exacerbations. A distinction between pre-eclamptic toxemia and lupus exacerbation had to be made in 25% of our patients. There were 2 maternal deaths associated with uncontrolled lupus activity. No potentially viable infants died for reasons directly related to lupus activity.