A Critical Review on Obstetric Follow-Up of Women Affected by Systemic Lupus Erythematosus

The document from April 1, 2018, critically reviewed the obstetric follow-up of women with Systemic Lupus Erythematosus (SLE) and found that these women are at a higher risk for maternal complications, pregnancy loss, and adverse perinatal outcomes. The review, which included 29 studies with sample sizes ranging from 40 to 1,526 SLE patients, identified factors such as lupus nephritis, hypertension, antiphospholipid antibodies, and disease activity as predictors of poor outcomes. It recommended that pregnancy in SLE patients should be planned during a period of disease inactivity, with close monitoring and a multidisciplinary approach involving obstetricians and rheumatologists. Safe medication options during pregnancy include hydroxychloroquine and azathioprine, while mycophenolate mofetil and other teratogenic drugs should be avoided. The review stressed the importance of preconception counseling, disease control, and management protocols to improve pregnancy outcomes for women with SLE. Despite the absence of randomized trials and potential publication bias, the review's conclusions are based on a wide range of studies and expert opinions.