Abstract

Background: Systemic lupus erythematosus (SLE) is an idiopathic, chronic autoimmune inflammatory disease with a high prevalence in females of reproductive age group. In the past, SLE patients were advised not to become pregnancy because of poor maternal and fetal outcomes. But nowadays the scenario has been changed because of pre-conceptional counselling and intense surveillance of disease during and after pregnancy. To study the effectiveness of pre-conceptional counselling in preventing adverse maternal and fetal outcomes among pregnant women with Systemic Lupus Erythematosus.
Materials and methods: It is a prospective observational study conducted among 32 women who were diagnosed with SLE and confirmed for pregnancy. Among these 32 women, 14 women have received pre-conceptional counselling and remaining 18 women did not receive pre-conceptional counselling prospectively. Maternal and fetal outcomes includes incidence of pre-eclampsia, lupus flare,f etal losses, fetal growth restrictions(FGR),preterm labor, neonatal lupus and oligohydramnios.
Results: Total of 32 SLE pregnancies were studied. The incidence of SLE in this hospital was 0.79 per 1000 pregnancies (32 out of 40032). 14 (43.7%) of women received pre-conceptional counselling,18 (56.2%) did not receive pre-conceptional counselling. Among women who received PCC 5(35.7%) cases developed late onset pre-eclampsia without severe features,3(21.4%)fetal wastage, 3 (21.4%) cases were pre term labour and 3 (21.4%) cases were diagnosed as FGR. Among women who did not receive PCC 9 (50%)cases developed pre-eclampsia, 9 (50%)fetal wastages 6 (33.3%) cases were pre term labour and 6 (33.3%) cases FGR were diagnosed.
Conclusions: Adverse maternal and fetal outcomes like preeclampsia, pre term labor, FGR, lupus flare and fetal wastage were high among women who did not receive pre-conceptional counselling compared to women received. Pre-conceptional counselling decreases the adverse outcome of the disease to large extent.