Průběh těhotenství a porodu u pacientkyse systémovým lupus erythematodes

Development of the Pregnancy and Labor in Patient withSystemic Lupus Erythematosus

Objective:
Pregnancy and its outcome in a woman with systemic lupus erythematosus.Subject: Case report.Setting: 1Obstetrics and Gynecology Department, Charles University, 2nd Medical Faculty andFaculty Hospital Motol, Prague, 2Cardiocentrum, University Hospital Motol, Prague.Subject: Patient with systemic lupus erythematosus (SLE) was admitted to our department at 31weeks of gestation with diagnosed fetal bradycardia. Detailed prenatal echocardiography revealedcomplete atrioventricular block (AVB III) with atrial rate of 140 b.p.m. and ventricular rate of70 b.p.m., fetoplacental failure was not present at initial examination.Patient was hospitalised for the remainder of the pregnancy, which continued to full-term with-out complications. During delivery, fetal pulse oxymetry was utilized to monitor fetal state saturationlevels. Labour proceeded without complications with an Apgar score of 9-9-9. The newbornwas observed at the ICU and the Cardiac center and deemed to be in stable condition with AVBIII without any signs of heart failure and without the necessity for pacemaker implantation.Conclusion: In cases of diagnosed fetal bradycardia, it is benefi cial to expand the methods of fetalmonitoring during labour. Pre-, peri-, and postnatal observation of pregnant women diagnosedwith SLE and fetal bradycardia should be done in specialised facilities that are able to providethe appropriate level of care for mother and infant.

Key words:
lupus erythematosus, fetal bradycardia, risk pregnancy