Volume : 7, Issue : 11, November - 2018

Fetal and Maternal Outcomes of Pregnancy in Severe Lupus Nephritis.

Divya Bajpai, Tukaram E. Jamale

Abstract :

<p>&nbsp;</p> <p class="MsoNormal" style="text-align:justify;line-height:200%"><b><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;">Objective. </span></b><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;">To evaluate the fetal and maternal outcomes of pregnancy in severe lupus nephritis.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align:justify;line-height:200%"><b><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;">Methods. </span></b><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;">Records of all women with severe lupus nephritis who had pregnancy during regular clinic follow-up were analysed. Fetal outcome studied were stillbirth, abortions (spontaneous/therapeutic), live birth, fetal distress, preterm birth, low birth weight, neonatal death, and congenital malformations. Preeclampsia, gestational hypertension, peripatum haemorrhage, gestational diabetes and maternal infections were evaluated along with renal flare related to pregnancy. Outcomes were compared between planned and unplanned pregnancies.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align:justify;line-height:200%"><b><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;">Results. </span></b><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;">Of 174 women screened, 36 pregnancies occurred in 26 women.<b> </b>22(61%) resulted in live births, 7(19.4%) underwent therapeutic termination, 5(13.8%) spontaneous abortions and 2(5.5%) stillbirths. 21 (58.4%) were planned pregnancies and they had significantly more live births than unplanned pregnancies (p = 0.0001). 8(22.2%) pregnancies were complicated with renal flare.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align:justify;line-height:200%"><b><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;">Conclusion. </span></b><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;">Although there is significant risk of adverse maternal and fetal outcomes in pregnancy with severe lupus nephritis, planned pregnancies can be successful with close monitoring and continuous therapy. Preconception counselling discussing the same will be beneficial.<b> <o:p></o:p></b></span></p>