Reproductive life planning and prenatal care in systemic lupus erythematosus

Reproductive life planning and prenatal care in systemic lupus erythematosus

A.A. Klimenko, N.A. Demidova, A.S. Gaffarova 

Pirogov Russian National Research Medical University, Moscow 

Systemic lupus erythematosus (SLE) is a common autoimmune disease that mainly affects women of reproductive age. Therefore, reproductive health issues are commonly faced by a rheumatologist and an obstetrician-gynecologist. Pregnancy in many patients with SLE is at high–risk for both the mother and the fetus. The article describes the patterns concerning the pregnancy onset and course in women with SLE. The article identifies the factors of complicated high-risk pregnancy and adverse outcome for mother and child, which primarily include the preserving clinical and serological disease activity, damage to vital organs (kidneys, heart, lungs), antiphospholipid antibodies in moderate and high titers. The article also considers the issues of reproductive life planning in patients with SLE and the examination plan of a woman during pregnancy. It is the competent reproductive life planning that is the prevention of its complicated course. Of fundamental importance is a good control of the disease activity and its manifestations with the help of drugs compatible with pregnancy. The issues concerning efficacy and safety of glucocorticoids, aminoquinoline derivatives, immunosuppressants, as well as antithrombotic agents during pregnancy are considered.

Keywords: systemic lupus erythematosus, pregnancy, autoantibodies, preeclampsia, glucocorticoids, immunosuppressants, antithrombotic therapy.

For citation: Klimenko A.A., Demidova N.A., Gaffarova A.S. Reproductive life planning and prenatal care in systemic lupus erythematosus. RMJ. 2023;7:37–43.