妊娠合并系统性红斑狼疮33例临床分析

目的探讨妊娠合并系统性红斑狼疮（SLE）的临床特点，及其孕产期处理及妊娠结局。方法对我院33例妊娠合并系统性红斑狼疮患者的临床资料进行回顾性分析，其中选择性妊娠19例，非选择性妊娠14例，分析比较患者妊娠病情变化和妊娠结局。结果其中选择妊娠组妊娠期病情加重9例（47．4％），胎儿丢失4例（21．1％）。非选择性妊娠组有12例（85．7％）病情均有不同程度加重，11例（78．5％）胎儿丢失。非选择性妊娠组的妊娠丢失率较选择性妊娠组高，差异有统计学意义（P〈0．05）。33例患者中，15例（45．45％）出现产科并发症，狼疮。肾炎12例（36．3％）。结论SLE患者需在产科和内分泌风湿科医生的指导下，在疾病缓解期受孕，加强母儿监护，适时结束分娩，重视产褥期监护及重视患者避孕情况。

A clinical analysis on pregnancy with systemic lupus erythematosus in 33 women

Objective To investigate the clinical characteristics, treatment, and pregnancy outcomes in pregnant women with systemic lupus erythematosus （ SLE ）. Methods The clinical data on 33 pregnant women with SLE were retrospectively reviewed to analyse the changes and outcomes of pregnancy, including 19 selective pregnancy （ selective group ）and 14 non-selective pregnancy （ non-selective group ）. Results SLE aggravated in 9 （ 47.4% ） pregnant women in the selective group, which included 4 fetal loss （ 21.1% ）. SLE aggravated in 12 （ 85.7% ）pregnant women in non-selective group, which included 11 fetal loss （ 78.5% ）. Rate of pregnancy loss was higher in selective group than in non-selective group （ P〈 0.05 ）. 15 of the 33 （ 45.45% ） patients developed obstetrics complications and 12 （ 36.3% ） developed lupus nephritis. Conclusions Patients with SLE should be under instruction by obstetricians and rheumatologists for preparing pregnacy. Those women should get pregnant during remission of SLE. Fetal and maternal monitoring should be fstrenghtened and pregnancy should be terminated properly. Attention should be paid to puerperium care and contraception