Pregnancy in women with systemic lupus erythematosus
- Peter H Schur, MD
Peter H Schur, MD
- Editor-in-Chief — Rheumatology
- Section Editor — Basic Science
- Professor of Medicine
- Harvard Medical School
- Bonnie L Bermas, MD
Bonnie L Bermas, MD
- Associate Professor of Medicine
- Harvard Medical School
- Section Editors
- David S Pisetsky, MD, PhD
David S Pisetsky, MD, PhD
- Section Editor — Lupus
- Professor of Medicine and Immunology
- Duke University Medical Center
- Charles J Lockwood, MD, MHCM
Charles J Lockwood, MD, MHCM
- Section Editor — Obstetrics
- Senior Vice President, USF Health
- Dean, Morsani College of Medicine
- Professor, Obstetrics and Gynecology
- University of South Florida
Systemic lupus erythematosus (SLE) occurs frequently in women of childbearing age. Although patients with SLE are as fertile as women in the general population, their pregnancies may be associated with complications. The prognosis for both mother and child is best when SLE has been quiescent and when renal disease in remission for at least six months prior to the pregnancy Thus, contraception and family planning are particularly important for women with SLE. Maternal health and fetal development should be monitored frequently during pregnancy. If possible, delivery should occur in a controlled setting. In addition, many women with SLE should be followed by an obstetrician knowledgeable in high-risk pregnancies .
Patients with SLE with one or more of the following features should be followed by an obstetrician experienced in management of high risk pregnancies :
●Prior history of poor obstetric outcomes
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- EXACERBATION OF SLE
- RENAL DISEASE
- Lupus nephritis
- Pregnancy following renal transplantation
- FETAL LOSS
- Role of antiphospholipid antibodies
- NEONATAL LUPUS
- OTHER CONSEQUENCES OF SLE
- BREAST FEEDING
- TREATMENT RECOMMENDATIONS
- - First visit
- - Monthly during the first two trimesters
- - End of each trimester
- - During the last trimester of pregnancy
- - Postpartum
- Treating active lupus
- - Medication use
- Moderate to high risk of fetal harm
- Selective use allowed during pregnancy
- Minimal fetal and maternal risk
- Unknown level of risk
- - Renal disease
- - Thrombocytopenia
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS