OBSTETRIC OUTCOME IN SYSTEMIC LUPUS-ERYTHEMATOSUS

A prospective study was performed to investigate the fetal and materna l outcome of 108 pregnancies in 90 lupus patients, The protocol was ba sed on shared care of the patients by a rheumatologist and an obstetri cian, with input from a hematologist, if necessary. Lupus flares were treated with low-dose prednisolone, azathioprine and hydroxychloroquin e. The live birth rate was increased from 31% in the patients' previou s obstetric history to 82%, A high incidence of prematurity was observ ed (43%). Lupus patients with secondary antiphospholipid syndrome pres ented a higher risk for fetal loss (P = .006). Flares occurred in 57% of the pregnancies, but most were mild (skin and joints). Flare during pregnancy did not increase the risk of fetal loss, We believe that ca reful monitoring and management of the lupus pregnancy has substantial ly improved the fetal outcome.