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Until a few years ago, women affected by Lupus were advised against getting pregnant due to the high risks involved for the mother and the child as well.
In the recent years however, a successful pregnancy is possible if all the recommended care and treatment is given to the mother and the fetus. Statistics reveal that only about 10% of pregnancies currently end in unexplained miscarriage for Lupus patients.
Early detection of the Lupus in pregnant women is vital to provide the right kind of treatment to protect the mother and the fetus from the disease. Pregnant women affected by Lupus will be screened for the for antiphospholipid antibodies, both the lupus anticoagulant (the RVVT and sensitive PTT are the best screening battery) and anticardiolipin antibody even if they do not have a history of previous miscarriage.
There are two major treatments available for the pregnant women. If the patient has a past venous or arterial thrombosis she would be therapeutically anticoagulated during the next pregnancy. But if the patient has pregnancy morbidity, i.e. late miscarriage or severe pre-eclampsia or placental insufficiency, she would be treated with prophylactic doses of heparin and a baby aspirin during the next pregnancy.
Pregnancy of a Lupus patient is a high risk affair, fetal monitoring, ultrasounds to monitor growth, placenta development and the biophysical profile from 26th week onwards. If there is irregular placenta growth an early C section would be done to save the baby.
Pregnant women with Lupus are likely to have multiple complications in their pregnancy including diabetes, urinary infections and pre-eclampsia hence it is appropriate to consult a high-risk obstetrician for pregnancy care.
Some patients with Lupus are advised to delay pregnancy or avoid it altogether, if they:
- have active lupus
- are taking medications such as Cyclophosphamide, Chlorambucil, Plaquenil and Azathioprine.
- have significant kidney damage
For those women affected by Lupus who wish to have a child should wait until their Lupus is inactive to try and conceive. It is advisable to wait until 6 months after the Lupus is in remission to start trying for the baby. |
