Ezgi TURGUT, Gökçe TURAN, Soheil KOOHNAVARD, Hamit KÜÇÜK, Abdurrahman TUFAN, Deniz KARÇAALTINCABA

SİSTEMİK LUPUS ERİTEMATOZUSLU GEBE KADINLARIN MATERNAL VE FETAL SONUÇLARININ DEĞERLENDİRİLMESİ

Amaç: Bu çalışmada sistemik lupus eritematozuslu (SLE) gebelerin obstetrik ve perinatal sonuçlarını değerlendirmeyi amaçladık. Gereçler ve yöntem: Bu çalışma 2010-2020 yılları arasında 35 SLE hastasının obstetrik sonuçlarını değerlendiren retrospektif bir çalışmadır. Lupus aktivitesi SLE Hastalık Aktivite İndeksi (SLEDAI) kriterlerine göre yapılmış ve gebelik sonuçları aktif ve inaktif SLE olarak gruplandırılarak değerlendirilmiştir. Bulgular: Ortalama maternal yaş 29 (21-39) idi. Antifosfolipid sendromu ve aktif hastalık oranı sırasıyla %5 ve %40 idi. 30 canlı doğum oldu. Biri majör kardiyak anomalili, diğeri renal agenezili olmak üzere iki gebelik terminasyonu rapor edildi. Aktif SLE grubunda bir spontan abortus ve 2 ölü doğum gözlendi. İntrauterin büyüme geriliği, preeklampsi ve erken doğum oranları sırasıyla %8, %20 ve %26 idi. Aktif SLE grubunda fetal kayıp ve erken doğum anlamlı olarak daha yüksekti (p=0,018, p=0,023). Aktif SLE grubunda daha yüksek yenidoğan yoğun bakım ünitesine (YYBB) yatış oranı gözlendi (p=0,034) ancak Apgar skorları 0,05). Sonuç: Bilimdeki gelişmelere rağmen, aktif SLE hastalığının, olumsuz gebelik sonuçlarına yol açma riski yüksektir. Yakın takip, özellikle erken doğumlar başta olmak üzere gebelik komplikasyonlarını azaltmaya yardımcı olabilir.

Anahtar Kelimeler:

Sistemik lupus eritematozus, aktif hastalık, perinatal sonuçlar

EVALUATION OF MATERNAL AND FETAL OUTCOMES OF PREGNANT WOMEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Aim: To evaluate obstetrical and perinatal outcomes of pregnancies with systemic lupus erythematosus (SLE). Materials and Method: This was a retrospective study evaluating obstetric outcomes of 35 patients with SLE who were followed up between 2010 and 2020. Lupus activity was based on SLE Disease Activity Index (SLEDAI) criteria and pregnancy outcomes were evaluated by grouping as active and inactive SLE. Results: The mean maternal age was 29 (21-39). The rate of antiphospholipid syndrome and active disease was 5% and 40% respectively. There were 30 live births. Two elective abortions were reported, one with major cardiac anomaly and the other with renal agenesis. One spontaneous abortion and 2 stillbirths were observed in the active SLE group. Overall rates of intrauterine growth retardation, preeclampsia, and preterm delivery were 8%, 20%, and 26%, respectively. Fetal loss and preterm delivery were significantly higher in the active SLE group (p=0,018, p=0,023). A higher rate of neonatal intensive care unit (NICU) admission was observed in the active SLE group (p=0,034) but Apgar scores less than 0,05). Conclusion: Despite advances in the medical sciences, an active disease with SLE has an elevated risk of inducing adverse pregnancy outcomes. Close follow-up could helps reduce pregnancy complications, especially preterm deliveries.

Keywords:

Systemic lupus erythematosus, active disease, perinatal outcomes,

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