Format

Send to

Choose Destination
Rev Med Interne. 2015 Mar;36(3):173-81. doi: 10.1016/j.revmed.2014.12.005. Epub 2015 Jan 8.

[Systemic lupus erythematosus and antiphospholipid syndrome: How to manage pregnancy?].

[Article in French]

Author information

1
Service de médecine interne, centre de compétence des maladies systémiques et auto-immunes rares de l'adulte, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France.
2
Service de médecine interne, pôle médecine, centre de référence maladies auto-immunes et systémiques rares, hôpital Cochin, université Paris Descartes, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France.
3
Service de gynécologie-obstétrique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France.
4
Service de gynécologie-obstétrique, DHU risques et grossesse, hôpital Cochin, université Paris Descartes, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France.
5
Département de médecine interne, centre de référence maladies auto-immunes et systémiques rares, université Paris 6, groupe hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France.
6
Service de médecine interne, pôle médecine, centre de référence maladies auto-immunes et systémiques rares, hôpital Cochin, université Paris Descartes, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France. Electronic address: nathalie.costedoat@gmail.com.

Abstract

Pregnancy in systemic lupus erythematosus patients is a common situation that remains associated with higher maternal and fetal mortality/morbidity than in the general population. Complications include lupus flares, obstetrical complications (fetal loss, in utero growth retardation, prematurity) and neonatal lupus syndrome. The association with antiphospholipid antibodies or antiphospholipid syndrome increases the risk of obstetrical complications. Improving the care of these pregnancies depends upon a systematic pregnancy planning, ideally during a preconception counseling visit and a multidisciplinary approach (internist/rheumatologist, obstetrician and anesthetist). The absence of lupus activity, the use of appropriate medications during pregnancy adjusted to the patient's medical history and risk factors, and a regular monitoring are the best tools for a favorable outcome for these high-risk pregnancies. The aim of this review article is to perform an update on the medical care of pregnancy in systemic lupus erythematosus or antiphospholipid syndrome to reduce the risk of complications and to ensure the best maternal and fetal prognosis.

KEYWORDS:

Adverse obstetrical outcome; Anti-SSA antibodies; Anticorps anti-SSA; Antiphospholipid syndrome; Complications obstétricales; Consultation pré-conceptionnelle; Grossesse; Lupus systémique; Preconception counseling; Pregnancy; Syndrome des antiphospholipides; Systemic lupus erythematosus

PMID:
25579465
DOI:
10.1016/j.revmed.2014.12.005
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center