The characteristic of PE (preeclampsia) complication at lupus on pregnancy

Agus Sulistyono and Andhita Hapsari and Erry Gumilar Dachlan and Hermanto Tri Joewono and M. Nadir Abdullah and Aditiawarman and Ernawati and Budi Wicaksono and Khanisyah Erza Gumilar and Manggala Pasca Wardhana and Nareswari Cininta I and Rozi Aditia and Muhammad Ilham Aldika Akbar (2018) The characteristic of PE (preeclampsia) complication at lupus on pregnancy. Pregnancy Hypertension, 13 (S.1). pp. 119-120. ISSN 2210-7789

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Background Indonesia had the serious challenge of highly maternal mortality over last ten years reflecting the real national health problem. There was 305 maternal death/100.000 deliveries, where 3 major possible cause of PE, PPH and infection persisted. Recently the new comer of diseases was standing tightly behind them: lupus on pregnancy. Material & Method This was a retrospective study from medical records.. Fifty-two cases of Lupus from 4592 pregnancy during 4 years (1.13%) have been observed in DR. Soetomo Teaching Hospital (tertiary hospital) Surabaya, Indonesia from January 2013 through December 2016. Results Sixteen cases of lupus were complicated by PE (30.7%), and 37.5% cases with Lupus Nephritis (that mostly showing increased serum creatinin level > 1.4 mg%). The maternal age were 25–34 years old (62.5%) and 62.5% were multigravida. Almost half cases (43.75%) got flare, leading to 25% early termination, while the remaining casesed (75%) were conservatively managed until 34 weeks gestation. Fetal outcome reported as 11 cases (68.75%) having birthweight > 2 kg, with 37.5% asphyxia (low apgar score). Discussion Pregnancy was discouraged in women affected by SLE, due to the disease becoming more aggresive during pregnancy and a poor pregnancy outcome was frequently reported. During pregnancy, the maternal immune system adapts to allow the growth of a semi-allogenic fetus. Significant immunological changes occur including suppression of type-2 helper cells (Th2), but the upregulation of Th1 cytokines in pregnancy may increase the risk for Th1-mediated diseases. The aboved concept was reflected at our study where most cases were sucessfully managed conservative until 34 weeks gestation and majority baby born with birthweight > 2 kg. Conclusions Our results suggest that lupus women are much more likely to develop worsening maternal spesifically preeclampsia and fetal outcomes when they become pregnant.

Item Type: Article
Uncontrolled Keywords: Preclamsia
Subjects: R Medicine > R Medicine (General)
R Medicine > RG Gynecology and obstetrics
Divisions: 01. Fakultas Kedokteran > Ilmu Kebidanan dan Kandungan
Agus SulistyonoNIDN8810800016
Andhita HapsariUNSPECIFIED
Erry Gumilar DachlanUNSPECIFIED
Hermanto Tri JoewonoNIDN8817900016
M. Nadir AbdullahUNSPECIFIED
Khanisyah Erza GumilarNIDN0005088405
Manggala Pasca WardhanaNIDN0020118404
Nareswari Cininta IUNSPECIFIED
Muhammad Ilham Aldika AkbarNIDN0018018203
Depositing User: hanif kurniawan
Date Deposited: 07 Jan 2021 03:23
Last Modified: 07 Jan 2021 03:23
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