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      Updates on lupus and pregnancy.

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      Bulletin of the NYU hospital for joint diseases

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          Abstract

          This review focuses on events subsequent to planning a pregnancy and addresses three components of concern for women with systemic lupus erythematosus: maternal, placental, and fetal. Flare rates are generally low for patients who are clinically stable at conception. For patients who have never had renal disease, there is no frm evidence that they will develop active renal disease simply due to being pregnant. For patients who begin pregnancy with an abnormal creatinine (> 2 mg/dl is ill advised), risks include hypertension, preeclampsia, high rate of fetal loss, and possible further deterioration of renal function. Discontinuation of angiotensin converting enzyme inhibitors, angiotensin receptor blockers, and mycophenalate is mandatory. Elevated levels of sVEGF-1 may be a harbinger of preeclampsia. For patients with anti-phospholipid antibodies detected in the frst trimester of pregnancy, the lupus anticoagulant per se may be the strongest predictor of pregnancy complications. For women with anti-SSA/Ro antibodies the risk of having a child with congenital heart block is 2% which rises to a recurrence rate of 18%. Information on current approaches to prevention and treatment of heart complications of neonatal lupus is provided.

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          Author and article information

          Journal
          Bull NYU Hosp Jt Dis
          Bulletin of the NYU hospital for joint diseases
          1936-9727
          1936-9719
          2009
          : 67
          : 3
          Affiliations
          [1 ] Division of Rheumatology, Department of Medicine, NYU Hospital for Joint Diseases, New York University Langone Medical Center, New York, New York 10019, USA. jill.buyon@nyumc.org
          Article
          NIHMS546396
          3904228
          19852749
          45b3c936-18b0-47f4-bcef-33f061a3a767
          History

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