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Recently, the prognosis of patients with SLE has remarkably improved and the number of patients with inactive SLE who become pregnant has increased. We experienced pregnancies with inactive SLE during a seven year period, and we analyzed them statistically regarding the outcome of mother and fetus in comparison with the active SLE pregnancies and normal pregnancies. In all 9 cases, the SLE had already been diagnosed and was clinically stable at the time of conception. Eight of 9 inactive SLE pregnant women, were being administrated various doses of prednisolone for the management of the SLE. In all nine cases the SLE was not aggrevated and severe renal exacerbation wasn't found throughout the pregnancy, but in 2 cases fever and arthritis occurred after parturition. The complement level and levels of complement component C3 and C4 were not remarkably different from in normal pregnancy. Spontaneous abortion and perinatal death didn't occur, but IUGR (Intrauterine Growth Retardation), fetal distress and toxemia (proteinuria) were found in high frequency compared with the normal pregnancies. Especially IUGR was characteristically present in inactive SLE pregnancy and it was probably related to the low placental weight and level of complements C 3 and C 4 but not to the prednisolone dose.In conclusion, the immunological disorder of SLE probably influences the fetus and placenta as much as Lupus nephritis. Thus, the management of pregnant women with SLE, even if in an inactive state, is considered to be important to the outcome for the mother and the fetus.
- 近畿産科婦人科学会の論文
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