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AHN 548 Exam 5 Autoimmune Diseases In Pregnancy Verified Study Solutions
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AHN 548 Exam 5 Autoimmune Diseases In Pregnancy Verified Study Solutions
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AHN 548 Exam 5 Autoimmune Diseases In PregnancyVerified Study Solutions
SLE is classified as having ANS At least 4:
Malar rash
Discoid rash
Photosensitivity
Oral ulcers
Arthritis
Serositis
Renal disorder
Leukopenia (< 4000/μL), lymphopenia (< 1500/μL), hemolytic anemia, or thrombocytopenia (<
100,000/μL)
Neurologic disorder
Positive test for anti-DNA, anti-Smith, or antiphospholipid antibodies
Antinuclear antibodies in high titers
SLE causes ANS -Unknown environmental triggers in genetically predisposed people.
-Some drugs (eg, hydralazine, procainamide,
isoniazid)
-Meds cause a reversible lupus-like syndrome.
SLE in pregnancy ANS 1. May first appear during pregnancy
2. women who have had unexplained 2nd-tri stillbirth
3. fetus with growth restriction
4. preterm delivery
5. recurrent spontaneous miscarriages
are often later diagnosed with SLE.
May worsen immediately postpartum
, SLE complications in pregnancy ANS -fetal growth restriction
-preterm delivery
-Preeclampsia
-congenital heart block due to maternal antibodies (anti-ssa and ssb) that cross the placenta.
-Lupus flare
-increases risk of perinatal mortality.
-maternal thromboembolic disorders. (SLE+antiphospholipid antibodies )
-Neonatal Lupus (10%): Rash, anemia, thrombocytopenia, or leukopenia; tend to resolve when
maternal antibodies disappear.
Treatment during pregnancy ANS Prednisone
Women w/antiphospholipid antibodies alos given aspirin
and prophylactic heparin
Severe, refractory SLE - immunosuppressants
hydroxychloroquine,imuran
Antiphospholipid syndrome diagnosis ANS Arterial or venous thrombosis or specific
pregnancy complications:
1) IUFD>10 WK
2) PTD, PET, IUGR<34 WK
3) ≥3 unexplained, RPL<10 weeks of gestation
AND
Lab evidence of antibodies to proteins bound to anionic phospholipids:
lupus anticoagulants (LA)
and anticardiolipin antibodies (aCL)
anti-beta-2-glycoprotein-1 antibodies
Antiphospholipid Syndrome Management ANS low-dose aspirin (ASA)
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