Publication:

Pregnancy in a woman with Henoch-Schönlein purpura: a case report

Henoch-Schonlein purpura (HSP), is an IgA-mediated small-vessel vasculitis that is uncommon in adults and rarely encountered in pregnancy. We report the pregnancy outcome of a 28-year-old woman with biopsy- and direct immunofluorescence-confirmed HSP. An unbooked patient presented at 38+4 weeks with fever, vomiting and decreased fetal movements. She underwent close maternal and fetal surveillance and supportive treatment. After spontaneous onset of labour, emergency lower-segment caesarean section was performed for non-progression of labour, resulting in delivery of a 3.360-kg live male infant. The postoperative course was complicated by lower respiratory tract infection with acute respiratory distress syndrome, requiring 5 days of intensive care and non-invasive ventilation; she subsequently recovered and was discharged on oral antibiotics. This case highlights the importance of multidisciplinary surveillance of renal function, blood pressure, maternal status and fetal wellbeing in pregnancies complicated by a history of HSP.