Maternal and perinatal outcome in autoimmune disorders complicating pregnancy

Abstract

Objective: To study the maternal and perinatal outcome in pregnant women with Autoimmune disorders like SLE, Rheumatoid arthritis, Systemic sclerosis, Sjogrens disease, Scleroderma, autoimmune hemolyticanemia. etc in a tertiary care teaching maternity hospital. Method: A total of 26 pregnant women with various Autoimmune disorders were identified among antenatal women attending the hospital between April 2011 to September 2013. They were evaluated, monitored and followed up with a standardized protocol to assess the pregnancy outcome. Results: Out of total 26 patients with Autoimmune disorders19 cases are diagnosed as SLE, 1 case Sjogrens syndrome, 2 case Systemic sclerosis, 1 case Scleroderma and 3 cases Rheumatoid arthritis. Out of 26 patients 19 have live births of which 12 are preterm and 7 are term deliveries.5 cases had IUD, 2 had spontaneous abortions. Of the 19 cases of SLE 11cases had positive antiphospholipid antibodies, 8cases had Anticardiolipin antibodies and 3 cases had lupusanticoagulant. One baby diagnosed as congenital heart block. One baby died after birth on 2 day. 12 cases delivered by caesarian section for indications of PROM, oligohydromnios, IUGR...etc. 6 had normal vaginal delivery and one case by forceps delivery. Conclusion: Pregnancy with autoimmune disorders have increased risk of spontaneous abortions, IUD, preterm delivery, small for gestational age, high perinatal morbidity and mortality. Cases managed in tertiary care hospitals have good perinal outcome though there is definite risk of prematurity and small for gestational age.