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Loving My Pain Free Life

Lupus: What To Consider Before Becoming Pregnant

9 May 2016

Claire Roberts

Although lupus is a chronic autoimmune disease that can make daily life difficult, it's not impossible to have a healthy and successful pregnancy. However, your lupus symptoms should be under control before you conceive. In preparing for pregnancy, it's important to discuss your desire to have a baby with your rheumatologist and an obstetrician as there are numerous factors to consider.

Limiting the Risks

Talking to your doctor before trying to become pregnant gives him or her the opportunity to review your health history and determine if you are healthy enough to carry a baby. Rheumatologists generally recommend having rheumatic disease, such as lupus, under control with no flares for 3 to 6 months before attempting pregnancy.

It's essential that you see your doctor, as certain past medical conditions can increase your risk of pregnancy complications. These include having had a history of :

• Kidney problems

• Hypertension

• Past pregnancy with preeclampsia

• Blood clots

• Low platelet count

You also are at increased risk for blood-clotting complications if you have antiphospholipid antibodies, which can slow fetal growth or lead to miscarriage, preeclampsia, or stillbirth. But if your lupus is in remission, you are at reduced risk of potential complications during pregnancy. Therefore, before trying to get pregnant, your rheumatologist may recommend a thorough physical exam, blood work, and tests to make sure that your kidneys are functioning well.

Understanding the Unpredictability of Lupus Flares

It's important to be as healthy as possible at the time you conceive since trying to have a baby when you are in an active flare poses certain risks for both you and your baby. Because the disease is so unpredictable, women who are in remission and have experienced no flares for months before becoming pregnant can still have a period of lupus flare activity during pregnancy.

Deciding About Medications

When discussing trying to get pregnant with your doctor, he or she may take you off of lupus medications that pose a risk to the fetus and then monitor your symptoms closely during that time. Although your doctor may allow you to stay on hydroxychloroquine (Plaquenil) and prednisone while you are trying to become pregnant to prevent a flare, he or she may stop the medications once you become pregnant. Not all immunosuppressive drugs your rheumatologist may prescribe if you suffer severe lupus symptoms are safe to take during pregnancy, as they can cause birth defects.

Knowing the Potential Complications

It's important to know the risks of becoming pregnant when you have lupus. You may experience flares that can cause any of the same lupus symptoms, such as joint and muscle pain, swelling, skin rashes and lesions, and potential organ damage, for which you are at risk even when you are not pregnant.

The risk for preeclampsia is greater in women with lupus; therefore, your obstetrician will monitor you closely for this potential pregnancy complication. The risk of miscarriage also is higher than in the general pregnant population.

In addition to the health risks associated with being born preterm, your baby may be born with neonatal lupus. Although the condition often is not permanent, some babies are born with a heart problem that does not go away and may require a pacemaker. Of the approximate 3 percent of babies born to mothers with lupus who are born with neonatal lupus, about half of them have abnormal heart rhythms that cause a slow heartbeat.

For more information on how Lupus will affect a pregnancy, contact a company like Bee Ridge Obstetrics Gynecology. 

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