Outcomes Of Pregnancy In Systemic Lupus Erythematosa

Methods: We have studied the medical registry of pregnant in SLE collected from January 2009 to January 2015. All the pregnant were diagnosed as SLE referring to the revisited criteria ACR (SLE/APLS) and have benefited from a long term follow-up in both specialized obstetrical center, immunoligical laboartory and internal specialized consulting. Results: 29 pregnant women of average age was of 29.1 years, SLE duration evolving about to 3.5 years and parity estimated at 2.5 by pregnant; Medical antecedent of abortion and recurrent pregnacy loss was reported in 34% ; pregnancies were authorized (30%) . Lupus pregnant history were summarized of lupus nephritis (9) requiring immunosuppressive therapy (7) with moderate to altered renal function (5) and thrombopenia (4). Thromboembolisms events (6) and infectious complications (tuberculosis and leishmaniasis) were mains complications in this cohorta. Antiphospholoipids antibodies `APL` were associated (44%).Treatment was adapted referring to the guidelines. Corticosteroid was increased to 10-15 mg prednisone daily, prophylactic dose of heparin and/or aspirin were required (100%) and azathioprine (40%) as consolidation treatment in sever forms (renal or heamatological). Dyslipemia (10), type 2 diabetes (4), and hypertension (4) were the cardiovascular risks factors `CVF` associated. Obstetrical complications as HELLP syndrome (4), pre-eclampsia (5), fetal losses or uteri-death (7), transient ischemic strokes (4), failure kidney (4), pulmonary arterial hypertension (2) and cardiomyopathy (2) were the main complications observed. Caesarians were required (75%) and were realized in emergency (25%).We noted hight frequency of gemellary pregnancy (24%) linked of ovarian stimulation (2). We deplore fetal deaths (7) by prematurity, respiratory distress and neo born infections and maternal death (17%) . Conclusion: Only 30% of pregnancy was programmed in SLE parturiente. Despite monitoring and long-time of SLE remission in our cohorta the pregnancy was associated in poor prognosis. The CVF, altered kidney function, infectious past history, high corticosteroid therapy, and the APLS were predictive to poor outcomes.