Effect of Self-Care Guideline on Quality of Life among Pregnant Women with Systemic Lupus Erythematosus

Abstract

Systemic lupus erythematosus is a chronic autoimmune inflammatory disease with varying degree of systemic involvement. There are 5 million people with SLE worldwide, 90% of whom are women in childbearing age between 15 and 44 years (Aly et al., 2016). Women with SLE often have disease flares, in which symptoms worsen, followed by a period of remission, in which symptoms improve. SLE is mild in some women and is life-threatening in others. However, treatment is available to reduce symptoms, reverse inflammation, and minimize organ damage. A variety of treatments can reduce symptoms, limit damage to vital organs, and reduce the risk of recurrence as glucocorticoids, such as prednisone, NSAIDs as aspocid, hydroxychloroquine and immunosuppressive agents. The choice of treatment for women with SLE is highly individualized, and is typically guided by the specific organs that are affected (Gergianaki and Bertsias, 2018). Historically, the general recommendation was against pregnancy in women with SLE due to the unfortunate maternal and fetal outcomes. However, over the past few years, the improved treatment allowed for the better control over the disease activity during pregnancy resulting in a remarkable improvement in the quality of life and pregnancy outcomes of these women. Nevertheless, there is still a considerable risk of maternal and fetal complications. Pregnancies in women with SLE pose a great challenge due to the risk of fetal loss, IUGR, prematurity, pre-eclampsia, and low birth weight (Aly et al., 2016). Hence, the maternity nurse working with a multidisciplinary collaborative team can play an important role to help pregnant women with SLE to enhance self-care strategy through educational activities to implement evidence-based, women-centred care guidelines to overcome uncertainties and difficulties in the management of SLE, to improve self-decision-making skills regarding their care, and to improve their quality of life and pregnancy outcomes (Wallace, 2017).