Lupus and Pregnancy: How to Get Pregnant Safely and Have Healthy Baby
Lupus and pregnancy are important discussions since women, who have lupus, may wonder whether they can get pregnant and gave birth safely. It is true that women with lupus have an increased risk of developing pregnancy complications. However, studies showed that less than 50% of pregnant women with lupus actually have complications. Some risks related to lupus in pregnancy include fetal loss, preeclampsia, premature delivery, and heart problems in the baby, among others.
Lupus and Pregnancy: How to Plan Pregnancy
Women with lupus still have huge chances of getting pregnant safely and having a healthy baby. The following tips may be helpful:
Get Medical Supervision
Before getting pregnant, make sure to assemble a health care team that will supervise and control you during the pregnancy. The team mostly includes an obstetrician for high-risk pregnancy, a rheumatologist, a perinatologist, and a pediatric cardiologist. The team will conduct a thorough evaluation of your health and risk before making some recommendations related to your lupus and pregnancy.
Women with lupus will require treatments at the early stage of the pregnancy or even before the conception. You will need several counseling sessions to discuss your personal health condition and determine the risks based on lupus you have. Not all women have similar conditions. Therefore, identifying your lupus is important as a part of pre-conception counseling.
Determine Personal Risk
This is actually still the part of pre-conception counseling. The medical team will determine your risks for complication based on your lupus. The analysis will include the following:
- Risks for first-trimester and third-trimester miscarriages
- The need for the blood test to check the presence of anti-phospholipid and anti-cardiolipin antibodies. These antibodies are responsible for blood clots and increased risk of stillbirth.
- The need for specific medications in women with a high risk of blood clots. They may include blood thinner medications, like heparin or low-dose aspirin.
- The need for anti-Ro/SSA and anti-La/SSB antibody screening. These antibodies are responsible for the increased risk of congenital heart block in babies.
- Chances of complications related to kidney and liver damages, which are common in lupus patients.
Modify Lupus Treatment
The need to modify lupus treatment to protect pregnancy is another part of pre-conception lupus and pregnancy counseling. The doctor will design a lupus treatment plan, which is safe for both the mother and the baby. A number of medications, such as hydroxychloroquine and prednisone, are considered safe for pregnant women. Meanwhile, other medications methotrexate and cyclophosphamide should be discontinued if you plan to have a baby.
Lupus and Pregnancy: Once You Get Pregnant
Once you become pregnant, you will need to take several steps to avoid the risks of complications and other lupus-related conditions. Following lupus and pregnancy tips may help you:
See Your Doctor Frequently and Regularly
Frequent doctor visits may help identify abnormal signs and symptoms earlier. They are also important to monitor fetal growth and to avoid lupus fatigue, which results from the feeling of worry. The doctors will monitor the blood pressure and urine protein, which often leads to increased risk for preeclampsia. Make sure to do following lupus and pregnancy visits:
- Visit your rheumatologist at least every trimester. Immediate visits are also important if you identify a lupus flare and necessary treatments with prednisone.
- Visit your obstetrician and perinatologist frequently and regularly. Follow their instructions about diet and exercises, rest, medication, and lifestyle changes.
- Follow the doctor’s recommendation on alcohol consumption, taking recreational drugs, smoking, and caffeine consumption.
- Follow the doctor’s recommendation on laboratory tests you will need once you get pregnant. They may include urinalysis, blood chemistry tests, complete blood count, anti-DNA antibodies, complement levels, and antibody tests mentioned above.
Watch for the Signs of Lupus Flare
Pregnant women are usually less likely to have lupus flares. However, risks still exist. If they do have lupus flares, the risks are even greater. Therefore, make sure to pay close attention to anybody changes that happen during pregnancy. Warning signs of lupus flares during pregnancy include:
- Joint swelling (edema), particularly in the knees
- Skin rashes, particularly around the face
- Hair loss or hair changes
Prepare for the Preterm Delivery
Premature delivery happens in about 50% of pregnancies in women with lupus. Preterm delivery means giving birth before 37 weeks. Meanwhile, delivery after 37 weeks is considered normal. Therefore, make sure to prepare preterm delivery and arrange your delivery at a hospital, which has a neonatal intensive care unit (NICU).
Overall, lupus and pregnancy are still safe in most women. Of course, the family needs careful planning to make sure that the mother can live healthily and deliver the baby safely. In addition, make sure to have a normal lifestyle and avoid lupus fatigue. Enough rest and a balanced diet are extremely important. This way, you can have a safe pregnancy and delivery.
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