Immunoadsorption plasmapheresis as a treatment for pregnancy complicated by systemic lupus erythematosus with positive antiphospholipid antibodies

PROBLEM: Our purpose was to study the effect of maternal immunoadsorption p lasmapheresis (IA) on the outcome of pregnancies complicated by systemic lu pus erythematosus (SLE) with positive antiphospholipid antibodies, which we re known to have a strong correlation with abortion or stillbirth. METHOD OF STUDY: Eight pregnancies in 7 patients with SLE were treated acco rding to our protocol. They were all positive for the lupus anticoagulant. The treatments provided in these cases were as follows: an oral low-dose st eroid; oral low-dose aspirin; and IA. The outcomes of the pregnancies were then studied. RESULTS: Of eight pregnancies, seven resulted in preterm deliveries, and ce sarean sections were performed at 26-36 weeks of gestation. In one case, in trauterine fetal death occurred at 24 weeks of gestation. The other seven p regnancies resulted in live births (survival rate of 87.5%). CONCLUSION: IA improves the outcome of pregnancy complicated by SLE with po sitive antiphospholipid antibodies, without increasing steroid dosage.