Lupus pregnancy refers to gestation in a woman with active systemic lupus erythematosus, an autoimmune disorder in which the immune system of the body begins to react against body’s own cells.
Lupus is a condition in which antibodies are formed against cells and manifest itself with rashes on face and other parts of the body. These antibodies can be harmful when directed to various organs in the body.
In more advanced stages, lupus antibodies involve kidneys, lungs, muscles, joints, and other vital organs. Like other autoimmune diseases, lupus also has flares followed by area of complete remission or disease-free state.
Before now doctors used to advice sufferers to avoid pregnancy due to high risk of complications associated with lupus, especially because pregnancy is characterized with physiological low immunity that can further aggravate lupus and possibly interfere with normal pregnancy-related activities in the body.
However, a lot of women can now safely become pregnant and are able to deliver healthy babies despite active Systemic Lupus Erythematosus (SLE) due to advancement in medicare technology. For some women, the condition of lupus improves during pregnancy, while it worsens for other moms with more flare-ups occurring at the instance of pregnancy.
There are certain potential risks involved when carrying a pregnancy with lupus. It’s therefore important you have requisite information about possible issues and side-effects of having pregnancy with lupus.
Assessment of your lupus status
The first step before conception is getting yourself completely checked to ascertain if your lupus is under-control. In order to have a complication-free pregnancy, it’s recommended that you must have at least 6 months of symptom-free period. With active and uncontrolled lupus, risk of complications is very high especially kidney, lungs or heart impairment.
Re-evaluation of your lupus medications
Once you plan to conceive in view of your symptom-free and controlled lupus, your next step is the re-evaluation of your lupus medications. Pregnancy is a low immunity state in which most cases of lupus recur, so it’s important for you to take all your lupus medications.
However, the question of whether you can continue to take your steroids (Corticosteroids is used to treat lupus) during pregnancy and how safe your usual lupus medication is during pregnancy must be addressed. For a safe lupus pregnancy, you must consult your doctor to check and re-assess what medications are safe for you during pregnancy.
For example, the following are confirmed unsafe medications for lupus during pregnancy; methotrexate, mofetil, leflunomide, cyclophosphamide, mycophenolate, mofetil, leflunomide and warfarin. Your healthcare provider will advise and instruct you appropriately.
Evaluation of cases of your lupus by an expert
When pregnancy co-exists with any medical condition mostly makes such pregnancy a high risk. The risk of complications in lupus pregnancy is especially high because lupus makes the expecting mom prone to other health issues like hypertension and accelerated kidney impairment or damage. It’s important to discuss your case with your healthcare provider before becoming pregnant.
The various complications associated with lupus during pregnancy include:
Lupus flares: Lupus flare is the most common symptom of lupus during pregnancy. However, this risk is fairly low in women who wait for at least 6 months symptom-free period. Apart from flare-ups, other symptoms of lupus include rashes, joint pain, skin sores, fever, and hypertension etcetera.
Pregnancy induced hypertension: Lupus during pregnancy increases the risk of pregnancy-induced hypertension in expecting mothers, of course with possibility to degenerate into eclampsia.
Risk of miscarriage: Recurrence of SLE (systemic lupus erythematosus) during pregnancy can severely affect the progression of pregnancy and even lead to miscarriage or preterm births. As well, babies born to women with lupus during pregnancy may have rash and birth defects such as low birth weight.
Therefore it is very important to take necessary measures to cope with any uninviting situation; the risk of miscarriage in lupus pregnancies is almost 20%.
Basically, antibody test or antinuclear antibody test are the blood tests conducted to diagnose lupus.
Following tips may help you in preventing complications associated with lupus pregnancy:
Although there is no cure for lupus, most lupus pregnancies when treated adequately can be delivered by vaginal birth; however in case of active lupus recurrence during late third trimester, cesarean section is the most preferred delivery option to avoid exposure of the newborn child to any complications from lupus pregnancy.