PREGNANCY AND SYSTEMIC LUPUS ERYTHEMATOSUS
Systemic lupus erythematosus (SLE) is an autoimmune disease that affects many human organs and systems. In patients with SLE a large number of antibodies to the antigens of their own cells is formed. It leads to an immunocomplex inflammatory process, which affects heart, skin, kidneys, lungs, joints, and the nervous system. SLE contributes to the failure of a fundamental characteristic of the immune system, namely tolerance to autoantigens. As a result, antibodies that attack normal tissues in many parts of the body are produced. This process is accompanied by autoimmune disease development. Patients with SLE demonstrate such clinical manifestations as multiple thrombosis, including pulmonary embolism (PE), CNS diseases, livedo reticularis, labile hypertension, habitual miscarriage. SLE affects people of all races, men and women, but it dominates in women and often develops in females of reproductive age. SLE prevalence among women of reproductive age is 1:500. Nearly 90 % of patients diagnosed with lupus are women. The reasons for SLE development are unknown. Now it is generally accepted, that gestational complications such as habitual abortion, preeclampsia and eclampsia, premature placental abruption, disseminated intravascular coagulation (DIC) and HELLP syndromes, thromboses, intrauterine growth retardation, and stillbirth are associated with maternal autoimmune diseases. However, the mechanism how SLE interferes with pregnancy and worsens its outcomes for the mother, fetus, and newborn remains unidentified. Probably, vascular lesions of the placenta contribute to the process, as their nature is similar to the lupus vascular disease in patients with SLE. Reproductive loss in SLE mothers, especially in clinically active lupus, can reach 45 %. The article analyzes the literature on the problems of interaction between SLE and pregnancy, the lupus clinical course in pregnant women, the maternal and perinatal gestational outcome, and neonatal lupus frequency.