Systemic Lupus Erythematosus FIRST TRIMESTER Baseline CBC, - TopicsExpress

Systemic Lupus Erythematosus FIRST TRIMESTER Baseline CBC, electrolytes, serum creatinine, liver enzymes, uric acid. Fasting blood glucose, fasting lipid profile if at high risk, for example if patient is nephritic or on steroids Normal antenatal check up ANA, Anti-DsDNA, anti-Ro and anti-La, antibody titers Complements levels (C3,C4,CH50) Anticardiolipin antibodies, lupus anticoagulant and ┚2 glycoprotein Urinalysis, 24-hour urine collection for measurement of protein and creatinine clearance SECOND TRIMESTER Baseline laboratory studies Anti-DsDNA Complements levels (C3,C4,CH50) , urinalysis Obstetric ultrasound: Every 4 weeks from 20 weeks of gestation until delivery “to monitor fetal growth” Mother with positive Anti-Ro and/or Anti-La antibodies, serial fetal echocardiography between 16-36 weeks of gestation THIRD TRIMESTER Repeat laboratory studies Urinalysis, 24-hour urine protein collection if proteinuria is present Weekly fetal non-stress test (NST) and/or biophysical profile (BPP) scoring from 28 weeks gestation Fetal Doppler ultrasonography to be done in presence of intrauterine growth restriction EACH VISIT Careful blood pressure measurement Urine dipstick for proteinuria Table 1. Guidelines for assessment of pregnant patients with lupus

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