Gamba, A.; Zen, M.; Depascale, R.; Calligaro, A.; Gatto, M.; Iaccarino, L.; Doria, A. Modern Management of Pregnancy in Systemic Lupus Erythematosus: From Prenatal Counseling to Postpartum Support. J. Clin. Med.2024, 13, 3454.
Gamba, A.; Zen, M.; Depascale, R.; Calligaro, A.; Gatto, M.; Iaccarino, L.; Doria, A. Modern Management of Pregnancy in Systemic Lupus Erythematosus: From Prenatal Counseling to Postpartum Support. J. Clin. Med. 2024, 13, 3454.
Gamba, A.; Zen, M.; Depascale, R.; Calligaro, A.; Gatto, M.; Iaccarino, L.; Doria, A. Modern Management of Pregnancy in Systemic Lupus Erythematosus: From Prenatal Counseling to Postpartum Support. J. Clin. Med.2024, 13, 3454.
Gamba, A.; Zen, M.; Depascale, R.; Calligaro, A.; Gatto, M.; Iaccarino, L.; Doria, A. Modern Management of Pregnancy in Systemic Lupus Erythematosus: From Prenatal Counseling to Postpartum Support. J. Clin. Med. 2024, 13, 3454.
Abstract
Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that predominantly affects women in the childbearing age. Pregnancy in SLE patients poses unique challenges due to the po-tential impact on maternal and fetal outcomes. We provide an overview of the management of SLE during pregnancy, including pre-conception risk stratification and counselling, treatment, and disease activity monitoring. These assessments are critical to minimize maternal and fetal adverse events in SLE pregnant patients. Disease flares, preeclampsia, antiphospholipid syn-drome complications, and maternal mortality are the major risks for a woman with SLE during gestation. Timely treatment of SLE relapse, differentiation of preeclampsia from lupus nephritis, and tailored management for antiphospholipid syndrome are essential for a successful pregnan-cy. Fetal outcomes include neonatal lupus (NL), preterm birth, cesarean delivery, fetal growth re-striction (FGR), and small for gestational age (SGA) infants. We focused on NL, linked to mater-nal anti-Ro/SS-A and anti-La/SS-B antibodies, which can lead to various manifestations, partic-ularly cardiac abnormalities in newborns. While there is a common consensus regarding the pre-ventive effect of hydroxychloroquine, the role of echocardiographic monitoring and fluorinated steroid treatment is still debated. Finally, close postpartum monitoring and counseling for sub-sequent pregnancies are crucial aspects of care.
Medicine and Pharmacology, Obstetrics and Gynaecology
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