Pregnancy with Systemic Lupus Erythematosus: A Case Report

Systemic Lupus Erythematosus (SLE) is a rare idiopathic autoimmune disease that was usually found in women of reproductive age. Pregnant women with SLE may have a higher risk of flares and pregnancy complications, including preterm birth, cesarean delivery, preeclampsia, low birth weight, intrauterine growth retardation (IUGR), congenital heart block (CHB), and intrauterine and neonatal mortality. Here we report a 33-year-old Balinese woman with a second pregnancy, controlled SLE, and history of retinal detachment. The patient was managed by a multidisciplinary team involving an obstetrician, rheumatologist, ophthalmologist, and pediatrician. The patient had methylprednisolone 4 mg once per day to control the SLE during pregnancies. Then, the drug was switched to dexamethasone 0.5 mg orally twice daily at 2 weeks before the due date. The patient routinely visited the Obstetrician and Rheumatology Polyclinic every 2 weeks. Later, the patient came to Emergency Ward and was diagnosed with premature rupture of membranes for more than 12 hours. Therefore, the cesarean section was chosen as the delivery method followed by bilateral tubectomy. The outcomes of pregnancy with SLE are very much affected by the activity of the disease. Our patient had controlled SLE before and during her pregnancy. Therefore, this patient had good pregnancy outcomes and the baby was also born healthy.