SLE in Pregnancy Flashcards
(21 cards)
Define SLE
**Systemic lupus erythematosus (SLE) is an idiopathic
autoimmune condition which has multi-organ involvement. **
Diagnosis is based on both clinical manifestations and
laboratory indices.
Most involved organ in SLE
The skin
Define criteria for diagnosis of SLE
- Malar rash
- Discoid rash
- Photosensitivity
- Oral ulcers
- Arthritis
- Pleuritis
- Renal disorders
- Neurological disorders
- Hematological
- Immunological
- Positive antinuclear antibody
4/11 well documented criteria makes it likely for SLE
Possible causes of SLE
- Environmental trigger such as ultraviolet light or a viral infection; for example, the Epstein–Barr virus
- combined with a genetic predisposition, forms the basis of the disease process.
elaborate the pre pregnancy counselling
- Conception to be advised at the period of quiescence
- Assessment of system involvement
Pregnant Women with SLE who are Anti-Ro/La positive, fetal echo should be done at
18-20 w then at 28w
As this is the period that congenital heart block can done
Risk of congenital heart block if mother has SLE with both anti-RO/LA.
2-3%
Risk of recurrence of congenital heart block if mother has SLE with both anti-RO/LA and having a previous baby with cong. Heart block.
15-20%
Best ttt of neonatal lupus rash
Expectant
Majority of SLE flares occurs in what part of pregnancy
Second half
Usual presentation of congenital heart block in fetuses of women with SLE+ anti ro/la
Fixed bradycardia 60-80 bpm
Do hydrops fetalis can occur in fetuses with women w/ anti Ro/La
Yes due to myocarditis
Rate of PROM in SLE
20%
Adverse effects of steroids on the mother
A. Increased glucose intolerance
B. Weight gain
C. Immunosuppression
E. Gastrointestinal irritation
F. Risk of infections
Maternal mortality rate, in SLE+ PHTN
33%
Prevelance of PHTN in patients with SLE
4.2%
Women with SLE with stable disease in pregnancy should be reviewed every
4 weeks
Risk of SLE flare in pregnancy is increased with active disease in the—- months prior to conception
3-6 months
The only definitive and reliable investigation that can be used to distinguish pre-eclampsia from lupus nephritis is
Renal biopsy
The prevalence of SLE in women of childbearing years is around
1 in 500
There is …% concordance for SLE in monozygotic twins
25%
