Earlier it was thought to be inadvisable for a woman with lupus to get pregnant due to the potential risk to the mother and the baby. These days advances in medicine have made it possible for women with lupus to have a safe pregnancy and improved pregnancy outcomes.
Chances of having a successful pregnancy are better if planned properly. Close monitoring by doctors is needed in such a pregnancy.
Risk Factors: Some factors that lead to a higher risk during such pregnancies are as follows:
- Kidney disease
- History of pre-eclampsia
- Low platelet count
- History of blood clots
- Presence of antiphospholipid
Planning for the pregnancy:
Although the pregnancy will always carry some risk, it is best to plan it when the lupus is not actively flaring up. The doctor should be consulted before beginning to try to conceive. He/she will adjust medications and advise when it is safe to try and conceive.
Pregnancy: Once conception has occurred the pregnancy needs to be monitored and managed by specialists. Some of the tests usually done are:
- Urinalysis – to check for protein in the urine
- Complete blood count
- Liver and kidney function test
- Antiphospholipid antibodies – to check for miscarriage risk
- Anti-DNA antibodies
- Complement levels
Complications: Pre-eclampsia, eclampsia, HELLP syndrome, Antiphospholipid antibodies, impaired kidney function, flares of lupus, pre-term delivery and foetal loss are some of the complications that may occur.
Neonatal lupus: The newborn may show symptoms of neonatal lupus. He/she may have a temporary skin rash, jaundice, low blood cell count. Normally all the symptoms disappear after six months. Chances of such a baby getting lupus later are minuscule.
Congenital heart blockage which may cause slow heartbeat may be present in the foetus. This is usually detected in the eighteen to twenty-four weeks foetus. Eventually, the child may need a pacemaker in such cases.
With all precautions in place, it is possible to have a smooth pregnancy for lupus patients. Though inherently a high-risk pregnancy, with medical knowledge, advances today a happy outcome to the pregnancy is expected.