Manifestation and management of pregnancy with systemic lupus erythematosus and/or preeclampsia

Abstract

Systemic lupus erythematosus (SLE) is a rheumatic illness that often affects pregnancy outcome of young women of reproductive age. Preeclampsia is a common gestational complication. SLE flare during pregnancy and preeclampsia share common clinical features, such as hypertension, proteinuria, and thrombocytopenia, making differentiation between these two conditions difficultly. The signs and symptoms of new-onset SLE during pregnancy or postpartum may mimic those of preeclampsia, while SLE associated arthritis/arthralgia, alopecia, and ulceration were less commonly found comparing with those non-pregnant patients. SLE is a risk factor for preeclampsia and both affect maternal and fetal outcomes. Changes in angiogenic factors precede the onset of preeclampsia in SLE pregnancies. Low-dose aspirin may decrease the risk for preeclampsia in pregnant women with SLE. Pregnant women should be treated for SLE flare rather than for preeclampsia for the better of the mother and baby when it is difficult to differentiate between these two conditions. Key words: Pre-eclampsia; Pregnancy complications; Lupus erythematosus, systemic; Diagnosis, differential