Fetal salvage in maternal systemic lupus erythematosus

Fifty-two pregnancies in 30 patients with systemic lupus erythematosus were studied prospectively. There were two spontaneous abortions, two therapeutic terminations for active disease, two intrauterine deaths before 28 weeks and one stillbirth. Forty-five (86.6%) pregnancies had a successful outcome. Five patients had renal involvement before or during pregnancy whilst 12 (23%) had preeclampsia. Placental insufficiency and intrauterine hypoxia contributed to a high Caesarean section rate (44%). The selection of patients for pregnancy, optimal medical care, antenatal monitoring and intensive neonatal care have improved fetal salvage in this condition.