SYSTEMIC LUPUS ERYTHEMATOSUS AND PREGNANCY: STRATEGIES BEYOND THE BASICS TO IMPROVE OUTCOMES IN PREGNANCY

Abstract

Objectives: To look those available strategies which can improve the outcome of women pregnancies those suff ering with SLE.

Materials and Methods: For this review, the two researchers conducted an extensive search  across various databases, including Web of Science, PubMed ,Scopus, and Medline. In addition, domestic databases such as https://pakmedinet.com and Google Scholar were explored. The search strategy involved employing specifi c keywords like "Systemic lupus erythematosus," "Pregnancy," "Strategies," "Maternal, fetal, or neonatal outcome," and "Improvement." The scope of the search encompassed articles published between January 2010 and January 2022. The PICO framework involves examining which interventions (strategies) are linked to an increased rate of successful normal pregnancies (outcome) in pregnant women with SLE (participants), relative to pregnant women without SLE (comparison).

Results: Based on our total 45 studies, our result demonstrates that pregnancies involving systemic lupus erythematosus (SLE) patients remain high-risk due to increased susceptibility to obstetric and neonatal complications. Maternal mortality rates are over 25-fold higher within SLE pregnancies. Despite vigilant monitoring, maternal and fetal morbidity remains elevated.  Immunological changes during pregnancy infl uence SLE activity, potentially triggering disease fl ares. Variability exists in SLE fl are risk during pregnancy due to diverse defi nitions and assessment tools. Strategies to improve outcomes involve preconception counseling, multidisciplinary monitoring, disease activity assessment, and postpartum surveillance. Lupus nephritis exacerbates risks, particularly with active disease during conception. Identifying these factors aids in better managing of these SLE women in high-risk pregnancies.

Conclusion: Tailored monitoring and preconception counseling are crucial for improved out comes. The complex interplay between SLE activity and pregnancy underscores the need for  refined assessment tools. Lupus nephritis accentuates risks, particularly with active disease at conception. A holistic, patient-centered approach is paramount to enhance outcomes in these challenging pregnancies.