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SLE WITH 2? APS IN PREGNANCY DR. SATYASNIGDHA TRIPATHY INTRODUCTION:- SLE is a multisystem autoimmune inflammatory disease which primarily affect women in their reproductive age group. Out of all SLE patients 90% are women. 90% of them are within 20- 40yrs age. Pathogenesis of SLE involves auto antibody production d/t overactive B lymphocytes, impaired T cell regulation, & subsequent deposition of immune complexes which result in tissue & cellular damage. May affect any organ system, joints>skin>lungs>nervous system> kidneys>heart are mostly affected. Fertility is generally unaffected in SLE, except in women with active disease, significant impairment of renal function or high dose corticosteroid or cyclophosphamide therapy which can result in ovarian dysfunction. Lupus pregnancies are Successful 2/3rd of the times. Mild to moderate lupus does quite well in pregnancy. Steroids are usually safe & 1st line drugs during exacerbation or Lupus flares. Continuing HCQ in pregnancy appears to reduce the risk of lupus flares during & after pregnancy CASE SUMMARY:- My pt. Mrs. Suchitra Swain,28yrs, G3P1L0A1 at GA 32 wks 3days,referred from Rheumatology dept. as a case of SLE with 2? APS with nephritis, severe Preeclampsia ,hypothyroidism was admitted with c/o Pain & swelling of b/l legs & hands, facial rash, palmoplantar rash & body ache for 15days . On Admission pt. had BP-160/90, P+I-E+++, urine alb-3+. Her obs. examination showed Ut.28-30 wk size, Cx long,soft,os closed, FHR-132/min on Doppler. Pt. was kept on inj. f/b oral anti-hypertensive (labetalol, nifedipin), inj.Dexona ,inj. MgSO4 neuroprotection dose started, Tab.HCQ, tab.thyroxine continued, Inj.LMWH put on hold. LSCS done (Ind-Severe Preeclampsia with uncontrolled htn with BOH) .LSCS/male/2kg/11.55AM/Vx delivery. Postoperatively pt had uncontrolled HTN?inj.labetalol infusion started along with inj.Lasix. Daily Rheumatology review done with advice to start Inj. LMWH from POD-3 & SLE medications eg. Inj. Hydrocortisone, Tab. HCQ continued. Postoperative period was uneventful. Pt. discharged on POD-8 with advice to attend Rheumatology OPD for further management of SLE