妊娠合并狼疮肾炎的妊娠预后和时机

目的 探讨妊娠合并狼疮肾炎的妊娠时机、预后与孕产期处理.方法 回顾性分析妊娠合并狼疮肾炎9例临床资料.结果 9例妊娠合并狼疮肾炎患者,在孕产期均出现不同程度的高血压、蛋白尿、肾功能受损和血清学异常等,其中流产2例,死胎1例,早产儿4例,足月产儿2例,未出现新生儿畸形和死亡,孕产妇无产后出血或死亡.活动期妊娠2例,妊娠丢失率为100%,其中1例出现病情恶化.在控制期和缓解期妊娠7例,妊娠丢失率为11.1%,前者与后者相比明显升高(P<0.05).结论 狼疮肾炎患者宜在疾病缓解期妊娠,孕产期正确使用肾上腺皮质激素,并加强母婴监护,才能够获得妊娠机会及安全渡过孕产期.

Pregnancy outcome in women with lupus nephritis

Objective To study the outcome of pregnancy with lupus nephritis. Methods The clinical data of 9 pregnancies with lupus nephritis were retrospectively malyzed. Results Hypertension,proteinuria,injured renal function and abnormal serological marker were complicated with nine patients with lupus nephritis in pregnancy. The outcome of pregnancy was as following:abortion 2 cases,stillbirth 1 case,premature delivery 4 cases,term delivery 2 cases. All neonate survived without malformation. There was no postpartum hemorrhage or death. Patients with active SLE had very high fetal mortality( 100% ). And SLE got worsen in 50% of them. However,fetal mortality rate in pa-tients with controlled or quiescent SLE was 11.1% ,which was much lower than it in other patients(P<0.05). Con-clusion Lupus nephritis should be controlled before pregnancy. Pregnancy outcome could be improved by careful multidisciplinary monitoring and proper usage of adrenal cortical hormone.