Περίληψη:
Objective: To record fetal and maternal outcome in pregnancies with
systemic lupus nephritis.
Subjects: Twelve pregnancies in 11 women with lupus nephritis were
studied. All patients were followed during the entire term of the
pregnancy and for 6 months postpartum. The laboratory studies performed
included antinuclear antibody titer (ANA), anti-DNA antibody titer,
complement component levels (C3 and C4), lupus anticoagulant,
anticardiolipin antibody, serum creatinine, 24-h urine protein, partial
thromboplastin time, VDRL, and tests of hematopoietic and hepatic
function.
Main Outcome Measures: Antenatal and postnatal complications of lupus
nephritis, proteinuria, hypertension, preterm delivery, birthweight, and
perinatal mortality.
Results: Twenty-five percent of pregnancies resulted in fetal loss, 58%
in premature delivery, and 17% in term delivery. There were no neonatal
deaths. All patients conceived during a period of clinical remission.
Flares of systemic lupus erythematosus (SLE) occurred in four patients.
Maternal renal function deteriorated in 25% of the pregnancies but this
was reversible in all cases. Increased proteinuria was recorded in 58%
of the pregnancies and was irreversible in two women (17%).
Hypertension occurred in 42% of the pregnancies, but permanent
hypertension postpartum was recorded in only one patient (8%).
Conclusions: SLE nephritis remains a high-risk condition for pregnancy.
Preeclampsia, prematurity, and fetal growth retardation frequently
complicate these pregnancies, and infant morbidity is high. Patients
should avoid pregnancy until all manifestations of nephritis are
quiescent.
Συγγραφείς:
Daskalakis, GJ
Kontessis, PS
Papageorgiou, IS and
Paraskevopoulos, AP
Digenis, GE
Karaiskakis, PT
Antsaklis,
AJ
Zerefos, NS
