certainly be aggravated as the pregnancy progresses and thus termination at an early stage of the pregnancy is necessary. 3. The actual moment of the pregnancy (less than 20 weeks) entails less risk for maternal complications than if the pregnancy progresses; thus, if it is prolonged there is a high risk of the occurrence of: - Major obstetric hemorrhage - Deterioration of the lupus - Worsening of her kidney failure - Severe preeclampsia, and complex forms of this condition such as hypertensive crisis, cerebral hemorrhage, arterial and venous thrombosis, and pulmonary thromboembolism - Post-partum infections - Maternal death d) The Health Minister indicated that “in this case the presence of lupus is classified as a severe maternal disease with high probabilities of the deterioration or death of the mother and, in view of the fetal anencephaly, it is necessary to deal with the matter urgently from a medical and legal perspective, [because the patient’s] condition is deteriorating as the pregnancy progresses”; 13 e) The “Latin American Center for Perinatology, Women and Reproductive Health” of the Pan-American Health Organization indicated that “according to the information, [B.] has the active disease of [systemic lupus erythematosus] with exacerbated symptoms as of the first trimester of the pregnancy and with two added complications of lupus nephrosis and hypertension, treated to date with numerous medicines that could jeopardize her health [and, t]herefore, she runs a high risk of dying if her pregnancy is not interrupted as soon as possible”; 14 f) On May 2, 2013, the Director of the Hospital where B. is interned advised that “although the patient’s disease is stable, […] owing to the physiological changes inherent in pregnancy, added to the natural history of the underlying disease, a crisis could occur at any time, and it cannot be predicted when a medical emergency may occur”; 15 g) On May 7, 2013, the Institute of Forensic Medicine indicated that “the pregnancies of women with [systemic lupus erythematosus] are at increased risk, owing to different adverse maternal or fetal perinatal outcomes, compared to those women who do not have this disease before they become pregnant. Higher rates of pre-term births, fetal death, limited inter-uterine growth, low birth weight, preeclampsia and obstetric hemorrhage have been identified.” The Institute added that “the disease of systemic lupus erythematosus in pregnancy has low mortality (1%); in addition, it is important to stress that, in these cases, maternal mortality occurs in the periods when the disease is active. The assessment of maternal and fetal mortality as the pregnancy 13 Communication of the Minister of Health addressed to the Supreme Court of Justice dated April 15, 2013 (file of request for provisional measures, annex 4). 14 Report of the “Latin American Center for Perinatology, Women and Reproductive Health” of the PanAmerican Health Organization of April 22, 2013 (file of request for provisional measures, annex 4). 15 Opinion of the Director of the National Maternity Hospital of May 2, 2013 (file of request for provisional measures, annex 7). 7