Objective: The objective of the investigation was to follow up the course of pregnancy in 32 women with systemic lupus erythematosus (SLE) and/or antiphospholipid syndrome (APS) and to evaluate selected clinical and laboratory parameters. Method: Clinical status, total SLE activity according to the SLEDAI score, treatment during pregnancy and selected haematological, biochemical and immunological parameters were investigated. The patients were examined before conception, at the onset of pregnancy and then after each trimester of pregnancy, and immediately after delivery. Results: Eighteen of the patients suffered from SLE, five had SLE with secondary APS and nine patients had primary APS. The majority of patients with SLE was treated with a small dose of corticosteroids, patients with APS took small doses of anopyrin as antiaggregation therapy. The total SLE activity was in the great majority of patients low, as apparent also from the low values of the SLEDAI score. Organ manifestation of SLE was present in two patients. All women with primary APS and 21 women with SLE had a pregnancy without complications and in term gave birth to a healthy child. These patients had at the onset and in the course of pregnancy a low clinical and laboratory activity of the disease and had no significant organ manifestations of SLE. Two women developed a serious life threatening exacerbation of the disease with severe manifestations of lupus nephritis with acute risk of survival of the foetuses. Both these patients had to be treated during pregnancy by combined immunosuppressive treatment, and premature delivery had to be induced. One of the neonates died on the fourth day, the second one survives and is doing well. Conclusion: Pregnancy took a normal course without complications and without exacerbation of the disease in all patients with primary APS and in 21 patients with SLE (without or with secondary APS), who had at the time of conception a low activity of the disease. In two patients with SLE who had also a low activity of the disease before conception exacerbation of SLE occurred during pregnancy with serious organ manifestation. Pregnancy was very complicated in these women, both had premature deliveris and one of the neonates died because of immaturity. Increased activity of SLE and the presence of organ manifestations during pregnancy were in the investigated group important predictors of the development of SLE as well as of the whole course of pregnancy.

        Key words: systemic lupus erythematosus, antiphospholipid syndrome, pregnancy, exacerbati- on of activity of the disease, organ manifestation