Analysis Of Pregnancy Outcomes In Pregnancies With Systemic Lupus Erythematosus

Objective: To invegestigate the obstetric complications,pregnancy outcome,the manner of delivery and the relationship of pregnancy complicated with Systemic lupus erythematosus（SLE）and the influence of type of drug,the history of adverse on pregnancy outcome.we try to provide the right time for conception,preinatal monitoring to prevent the deterioration of the two diseases and pregnancy loss and improve the preinatal quality.Methods: we reviewed the medical records of 84 women with SLE and 44 women with UCTD treated from January1,2010 to December31,2016 in Tianjin medical university general hospital.We mainly divided into the following four groups to study.（11）According to the disease state of SLE before pregnancy,84 patients were divided into stable pregnancy SLE group 55 cases（A group）and SLE activity group 29cases（B group）;（12）According to the disease state of SLE in pregnancy,84 patients were divided into stable pregnancy SLE group 46 cases（C group）and SLE activity group 38cases（D group）;（13）According to type of medication,84 patients were divided into group E,group F and group G.（14）According to accompanying adverse pregnancy Whether or not,84 patients were divided into two groups.Statistical calculations were performed with SPSS version 19.0.A p-value <0.05 was considered significant.Results:（11）With respect to 84 pregnancies with SLE: The mean age was 29.89±4.27（range 21-41）.The mean clinical course of SLE was4.89±3.82 years（range 0-16）.The mean gestation age was 35.35±6.14 weeks(range16-40⁺⁶).Besides,6 cases（7.1%）with SLE was found at the beginning of pregnancy,6 cases（7.1%）with APS and 87 cases（8.3%）with lupus nephritis（LN）.（12）The effection of SLE condition on pregnancy outcome: In 84 cases of SLE patients,11 cases（13.1%）of pregnancy loss,23 cases（27.4%）of preterm birth,the term birth of 50 cases（59.5%）.There was statistically significant difference about pregnancy loss,premature birth,the term production between stable group and activity group no matter before or during pregnancy（P<0.05）.（13）The effection of SLE condition on obstetric complications: stable group and activity group before pregnancy have 55 cases（65.5%）and 29cases（34.5%）;stable group and activity group during pregnancy have 46 cases（54.8%）and 38 cases（45.2%）.PIH 23 cases（27.4%）.Between stable group and activity group before pregnancy,PIH had statistical significance（P<0.05）;There was no statistically significant difference in the fetal distress,FGR and PROM（P>0.05）.Between stable group and activity group during pregnancy,PIH and FGR had statistical significance（P< 0.05）;There was no statistically significant difference in the fetal distress and PROM（P>0.05）.（14）56 cases of cesarean delivery out of 84 cases of SLE patients（66.7%）,18 cases（21.4%）of vaginal birth,10 cases（11.9%）of mid-induced labor.There was no statistically significant difference on cesarean section between stable group and activity group no matter before or during pregnancy（P>0.05）.（15）The effection of type of medication on pregnancy outcome: The comparison between the three group of two,respectively,pregnancy loss,premature and full-term pregnancy had no statistically significant difference（P>0.05）.（16）43 cases of SLE patients have a history of adverse pregnancy（such as abortion,stillbirth）,accounting for 51.2%（43/84）.There was no statistically significant difference in pregnancy loss,premature and full-term pregnancy.Conclusions:（11）Therefore,supervision should be conducted by obstetrician,rheumatologist and other departments.The pregnancy outcomes have improved significantly by supervision.（12）The pregnancies with SLE belong to high risk of patients,and prone to adverse pregnancy outcomes and lupus flare during pregnancy.（13）Obstetric complications and fetal outcome is relatively good when the pregnancy was planned after disease remission.（14）SLE disease activity can cause PIH.To strengthen the reasonable treatment of a variety of complications during pregnancy in time and make the stable condition is improving the maternal-fetal ending.（15）The fetals from SLE pregnancies belong to high risk fetals.It’s necessary to strengthen the B ultrasound in order to find the presence of fteal congenital heart block in time.