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Sistemik Lupus Eritematozuslu 126 Gebenin Perinatal Sonuçları

Yıl 2018, Cilt: 81 Sayı: 2, 51 - 55, 29.05.2018

Öz

DOI: 10.26650/IUITFD.344912


Amaç: Sistemik lupus eritematozus (SLE)
tanısı almış ve gebe olan olguların maternal ve perinatal sonuçlarının
değerlendirilmesi amaçlanmıştır.

Gereç ve Yöntem: Çalışmamız 2002-2016
yılları arasında üniversitemizin perinataloji kliniğinde gebelikleri takip
edilmiş 126 SLE olgusunun dosya verilerinin retrospektif olarak incelenmesiyle
yapıldı. Hastaların klinik karakteristikleri, obstetrik ve perinatal sonuçları
değerlendirildi.

Bulgular: Hastaların ortalama yaşı 29,1±
4,6 yıl ve nulliparite oranı %45,2 idi. Gebelik sırasında hastalığın
alevlenmesi hastaların %11,1’ inde görüldü. Lupus antikoagulanı,
antikardiyolipin IgG ve IgM antikorlarının pozitifliği sırasıyla; %23,8 , %18,2
ve  %18,2 olarak saptandı. Ortalama doğum
haftası 37,2±3,7, ortalama doğum kilosu 2813 ±856 gr bulundu. Fetal büyüme
kısıtlılığı, preterm doğum, ölü doğum, preeklampsi görülme oranları sırasıyla;
%16,6 , %10,3 , %10,3 , %9,5 olarak bulundu.







Sonuç: SLE tanılı gebelik olgularının
yönetiminde multidisipliner yaklaşım ile takip ve tedavinin sağlanması olumlu
maternal ve fetal sonuçlar ile ilişkilidir.

Kaynakça

  • 1. D’Cruz DP, Khamashta MA, Hughes GRV. Systemic lupus erythematosus. Lancet 2007;369(9561):587–96.
  • 2. Smyth A, Garovic VD. Systemic lupus erythematosus and pregnancy. Minerva Urol 2009;Nefrol 61(4):457–74.
  • 3. Doria A, Tincani M, Lockshin MD. Challenges of lupus pregnancies. Rheumatology 2008;47(3):9–12.
  • 4. Brucato A, Frassi M, Franceschini F, Cimaz R, Faden D, Pisoni MP et al. Risk of congenital complete heart block in newborns of mothers with anti-Ro/SSA antibodies detected by counter immunoelectrophoresis. A prospective study of 100 women. Arthritis Rheum 2001;44(8):1832–5.
  • 5. Derksen RH, Bruinse HW, de Groot PG, Kater L. Pregnancy in systemic lupus erythematosus: a prospective study. Lupus 1994; 3(3):149–55.
  • 6. Wong CH, Chen TL, Lee CS, Lin CJ, Chen CP.nOutcome of pregnancy in patients with systemic lupus erythematosus. Taiwan J Obstet Gynecol 2006;45(2):120–3.
  • 7. Yan Yuen S, Krizova A, Ouimet JM, Pope JE. Pregnancy outcome in systemic lupus erythematosus (SLE) is improving: Results from a case control study and literature review. Open Rheumatol J 2008;2:89–98.
  • 8. Teh CL, Wong JS, Ngeh NK, Loh WL. Systemic lupus erythematosus pregnancies: a case series from a tertiary, East Malaysian hospital. Lupus 2009;18:(3):278–82.
  • 9. Ambrosio P, Lermann R, Cordeiro A, Borges A, Nogueira I, Serrano F .Lupus and pregnancy—15 years of experience in a tertiary center. Clin Rev Allergy Immunol 2010;38:(2-3) 77–81.
  • 10. Petri M, Howard D, Repke J. Frequency of lupus flare in pregnancy: the hopkins lupus pregnancy center experience.Arthritis Rheum 1991;34:(12)1538–45.
  • 11. Ruitz-Irastorza G, Lima F, Alves J, Khamashta MA, Simpson J,Hughes GR et al. Increased rate of lupus flare during pregnancy and the puerperium. Br J Rheumatol 1996;35:(2)133–38
  • 12. Clowse ME, Jamison M, Myers E, James AH. A national study of the complications of lupus in pregnancy. Am J Obstet 2008; Gynecol 199(127):e1–e6.
  • 13. Hochberg MC. Updating the american college of rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997; 40:(9)1725.
  • 14. Mok CC, Wong RWS. Pregnancy in systemic lupus erythematosus. Postgrad Med J 2001;77(905):157–65.
  • 15. Mauragani CP, Dafni UG, Tzioufas AG, Moutsopoulos HM. Pregnancy outcome and anti-Ro/SSA in autoimmune disease. A retrospective cohort study. Br J Rheumatol 1998; 37:(7) 740–45.
  • 16. Georgiou PE, Politi EN, Saka V, Drosos AA. Outcome of lupus pregnancy: a controlled study. Rheumatology 2000; 39(9):1014–9.
  • 17. Cavallasca J, Laborde H, Ruda-Vega H, Nasswetter G. Maternal and fetal outcomes of 72 pregnancies in Argentine patients with systemic lupus erythematosus (SLE). Clin Rheumatol 2008;27:(1) 41–6.
  • 18. Petri M, Allbritton J. Fetal outcome of lupus pregnancy: a retrospective case-control study of the HopkinsLupus Cohort. Obstetric Gynecol Surv 1993; 48:(4):717–8.
  • 19. Witter FR, Petri M. Antenatal detection of intrauterine growth restriction in patients with systemic lupus erythematosus.Int Gynaecol Obstet 2000;71:(1)67-8.
  • 20. Chakravarty EF, Colon I, Langen ES, Nix DA, El-Sayed YY, Genovese MC et al. Factors that predict prematurity and preeclampsia in pregnancies that are complicated by systemic lupus erythematosus. Am J Obstet Gynecol 2005; 192:(6)1897–1904
  • 21. Priyadarshani Galappatthy, Jayan D. D. Jayasinghe, Sampath C. Paththinige, Rezvi M. H. Sheriff and Lalith S. Wijayaratn. Pregnancy outcomes and contraceptive use in patients with systemic lupus Erythematosus, rheumatoid arthritis and women without a chronic illness: a comparative study. International Journal of Rheumatic Diseases 2017;20:(6):1-9.
  • 22. Aggarwal N, Raveendran A, Suri V, Chopra S, Sikka P, Sharma A. Pregnancy outcome in systemic lupus erythematosus: Asia’s largest single centre study. Arch Gynecol Obstet 2011;284:(2) 281-5.
  • 23. Caroline L Knight, Catherine Nelson-Piercy. Management of systemic lupus erythematosus during pregnancy: challenges and solutions. Open Access Rheumatology: Research and Reviews 2017;9:(1) 37-53.

Perinatal Outcomes Of 126 Pregnancies With Sistemic Lupus Erythematosus

Yıl 2018, Cilt: 81 Sayı: 2, 51 - 55, 29.05.2018

Öz

DOI: 10.26650/IUITFD.344912


Objective: To evaluate maternal and fetal
outcomes in pregnant women with systemic lupus erythematosus (SLE).

Materials and Methods: This retrospective
clinical study included 126 consecutive cases of pregnant women with SLE and
was performed in the perinatology clinic of our university hospital. We
evaluated lupus pregnancies that were followed and delivered from 2002 to 2016.

Results: The mean patient age was 29.1 ±
4.6 years, and the nulliparity rate was 45.2%. Disease flare-up occurred in
11.1% of patients. Lupus anticoagulants and anticardiolipin IgG and IgM
antibodies were positive in 23.8%, 18.2%, and 18.2% patients, respectively. The
mean gestational age at delivery was 37.2 ± 3.7, and the mean birth weight was
2813 ± 856 g. Fetal growth restriction, preterm delivery, stillbirth, and
preeclampsia rates were 16.6%, 10.3%, 10.3%, and 9.5%, respectively.







Conclusion:
A multidisciplinary approach to the care of pregnant women with SLE is
mandatory for good maternal and fetal outcomes.

Kaynakça

  • 1. D’Cruz DP, Khamashta MA, Hughes GRV. Systemic lupus erythematosus. Lancet 2007;369(9561):587–96.
  • 2. Smyth A, Garovic VD. Systemic lupus erythematosus and pregnancy. Minerva Urol 2009;Nefrol 61(4):457–74.
  • 3. Doria A, Tincani M, Lockshin MD. Challenges of lupus pregnancies. Rheumatology 2008;47(3):9–12.
  • 4. Brucato A, Frassi M, Franceschini F, Cimaz R, Faden D, Pisoni MP et al. Risk of congenital complete heart block in newborns of mothers with anti-Ro/SSA antibodies detected by counter immunoelectrophoresis. A prospective study of 100 women. Arthritis Rheum 2001;44(8):1832–5.
  • 5. Derksen RH, Bruinse HW, de Groot PG, Kater L. Pregnancy in systemic lupus erythematosus: a prospective study. Lupus 1994; 3(3):149–55.
  • 6. Wong CH, Chen TL, Lee CS, Lin CJ, Chen CP.nOutcome of pregnancy in patients with systemic lupus erythematosus. Taiwan J Obstet Gynecol 2006;45(2):120–3.
  • 7. Yan Yuen S, Krizova A, Ouimet JM, Pope JE. Pregnancy outcome in systemic lupus erythematosus (SLE) is improving: Results from a case control study and literature review. Open Rheumatol J 2008;2:89–98.
  • 8. Teh CL, Wong JS, Ngeh NK, Loh WL. Systemic lupus erythematosus pregnancies: a case series from a tertiary, East Malaysian hospital. Lupus 2009;18:(3):278–82.
  • 9. Ambrosio P, Lermann R, Cordeiro A, Borges A, Nogueira I, Serrano F .Lupus and pregnancy—15 years of experience in a tertiary center. Clin Rev Allergy Immunol 2010;38:(2-3) 77–81.
  • 10. Petri M, Howard D, Repke J. Frequency of lupus flare in pregnancy: the hopkins lupus pregnancy center experience.Arthritis Rheum 1991;34:(12)1538–45.
  • 11. Ruitz-Irastorza G, Lima F, Alves J, Khamashta MA, Simpson J,Hughes GR et al. Increased rate of lupus flare during pregnancy and the puerperium. Br J Rheumatol 1996;35:(2)133–38
  • 12. Clowse ME, Jamison M, Myers E, James AH. A national study of the complications of lupus in pregnancy. Am J Obstet 2008; Gynecol 199(127):e1–e6.
  • 13. Hochberg MC. Updating the american college of rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997; 40:(9)1725.
  • 14. Mok CC, Wong RWS. Pregnancy in systemic lupus erythematosus. Postgrad Med J 2001;77(905):157–65.
  • 15. Mauragani CP, Dafni UG, Tzioufas AG, Moutsopoulos HM. Pregnancy outcome and anti-Ro/SSA in autoimmune disease. A retrospective cohort study. Br J Rheumatol 1998; 37:(7) 740–45.
  • 16. Georgiou PE, Politi EN, Saka V, Drosos AA. Outcome of lupus pregnancy: a controlled study. Rheumatology 2000; 39(9):1014–9.
  • 17. Cavallasca J, Laborde H, Ruda-Vega H, Nasswetter G. Maternal and fetal outcomes of 72 pregnancies in Argentine patients with systemic lupus erythematosus (SLE). Clin Rheumatol 2008;27:(1) 41–6.
  • 18. Petri M, Allbritton J. Fetal outcome of lupus pregnancy: a retrospective case-control study of the HopkinsLupus Cohort. Obstetric Gynecol Surv 1993; 48:(4):717–8.
  • 19. Witter FR, Petri M. Antenatal detection of intrauterine growth restriction in patients with systemic lupus erythematosus.Int Gynaecol Obstet 2000;71:(1)67-8.
  • 20. Chakravarty EF, Colon I, Langen ES, Nix DA, El-Sayed YY, Genovese MC et al. Factors that predict prematurity and preeclampsia in pregnancies that are complicated by systemic lupus erythematosus. Am J Obstet Gynecol 2005; 192:(6)1897–1904
  • 21. Priyadarshani Galappatthy, Jayan D. D. Jayasinghe, Sampath C. Paththinige, Rezvi M. H. Sheriff and Lalith S. Wijayaratn. Pregnancy outcomes and contraceptive use in patients with systemic lupus Erythematosus, rheumatoid arthritis and women without a chronic illness: a comparative study. International Journal of Rheumatic Diseases 2017;20:(6):1-9.
  • 22. Aggarwal N, Raveendran A, Suri V, Chopra S, Sikka P, Sharma A. Pregnancy outcome in systemic lupus erythematosus: Asia’s largest single centre study. Arch Gynecol Obstet 2011;284:(2) 281-5.
  • 23. Caroline L Knight, Catherine Nelson-Piercy. Management of systemic lupus erythematosus during pregnancy: challenges and solutions. Open Access Rheumatology: Research and Reviews 2017;9:(1) 37-53.
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Ayşegül Özel 0000-0002-0283-1049

Ebru Alıcı Davutoğlu Bu kişi benim 0000-0003-1634-0117

Hakan Erenel Bu kişi benim 0000-0001-7583-5385

Mehmet Fatih Karslı Bu kişi benim 0000-0001-8524-2428

Sevim Özge Korkmaz Bu kişi benim 0000-0003-2862-0802

Rıza Madazlı Bu kişi benim 0000-0002-6400-1964

Yayımlanma Tarihi 29 Mayıs 2018
Gönderilme Tarihi 17 Ekim 2017
Yayımlandığı Sayı Yıl 2018 Cilt: 81 Sayı: 2

Kaynak Göster

APA Özel, A., Alıcı Davutoğlu, E., Erenel, H., Karslı, M. F., vd. (2018). Sistemik Lupus Eritematozuslu 126 Gebenin Perinatal Sonuçları. Journal of Istanbul Faculty of Medicine, 81(2), 51-55.
AMA Özel A, Alıcı Davutoğlu E, Erenel H, Karslı MF, Korkmaz SÖ, Madazlı R. Sistemik Lupus Eritematozuslu 126 Gebenin Perinatal Sonuçları. İst Tıp Fak Derg. Mayıs 2018;81(2):51-55.
Chicago Özel, Ayşegül, Ebru Alıcı Davutoğlu, Hakan Erenel, Mehmet Fatih Karslı, Sevim Özge Korkmaz, ve Rıza Madazlı. “Sistemik Lupus Eritematozuslu 126 Gebenin Perinatal Sonuçları”. Journal of Istanbul Faculty of Medicine 81, sy. 2 (Mayıs 2018): 51-55.
EndNote Özel A, Alıcı Davutoğlu E, Erenel H, Karslı MF, Korkmaz SÖ, Madazlı R (01 Mayıs 2018) Sistemik Lupus Eritematozuslu 126 Gebenin Perinatal Sonuçları. Journal of Istanbul Faculty of Medicine 81 2 51–55.
IEEE A. Özel, E. Alıcı Davutoğlu, H. Erenel, M. F. Karslı, S. Ö. Korkmaz, ve R. Madazlı, “Sistemik Lupus Eritematozuslu 126 Gebenin Perinatal Sonuçları”, İst Tıp Fak Derg, c. 81, sy. 2, ss. 51–55, 2018.
ISNAD Özel, Ayşegül vd. “Sistemik Lupus Eritematozuslu 126 Gebenin Perinatal Sonuçları”. Journal of Istanbul Faculty of Medicine 81/2 (Mayıs 2018), 51-55.
JAMA Özel A, Alıcı Davutoğlu E, Erenel H, Karslı MF, Korkmaz SÖ, Madazlı R. Sistemik Lupus Eritematozuslu 126 Gebenin Perinatal Sonuçları. İst Tıp Fak Derg. 2018;81:51–55.
MLA Özel, Ayşegül vd. “Sistemik Lupus Eritematozuslu 126 Gebenin Perinatal Sonuçları”. Journal of Istanbul Faculty of Medicine, c. 81, sy. 2, 2018, ss. 51-55.
Vancouver Özel A, Alıcı Davutoğlu E, Erenel H, Karslı MF, Korkmaz SÖ, Madazlı R. Sistemik Lupus Eritematozuslu 126 Gebenin Perinatal Sonuçları. İst Tıp Fak Derg. 2018;81(2):51-5.

Contact information and address

Addressi: İ.Ü. İstanbul Tıp Fakültesi Dekanlığı, Turgut Özal Cad. 34093 Çapa, Fatih, İstanbul, TÜRKİYE

Email: itfdergisi@istanbul.edu.tr

Phone: +90 212 414 21 61