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Can Lupus Affect Pregnancy and Conception?

Dear Anai,

Can I have a healthy pregnancy despite my Lupus?

Answer:

Years ago, medical texts claimed that women with lupus could not have children, and if they became pregnant, they should have abortions. Nowadays we know different. There is more and more evidence that it is possible to have lupus and continue on with a succussful pregnancy. Keep in mind that is still considered a high risk pregnancy. In order for things to go smoothly, you will need to keep a few things in mind.

Below is a list of what you will need to do:

• Choose a doctor that is familiar with Lupus in pregnancy
• Remember that you will need to make arrangements with a hospital for delivery, not a doula/midwife.
• Visit the hospital ahead of time to make sure they have a complete access to a unit for preemies, in case you deliver early.

Is there a chance that my pregnancy will worsen my lupus?

Recent studies indicate that flare ups are not as common as they first suspected. If there is a incident, know that it is easily treatable. Notify your doctor right away, so that she or he can take care of it quickly. Frequent doctor visits are important in any high risk pregnancy. Most conditions which may occur can be prevented, if found early enough, can be treated more easily more effectively.

If I do have a flare up, when will it most likely happen?

If there is a flare up, it will most likely occur during early pregnancy (1st and early part of second trimester) or you may notice it happening sometimes in the months following your baby's delivery. Women who conceive after 6 months of remission, are less likely to experience a lupus flare up than those who get pregnant while their lupus is active.

What are the symptoms?

The most common symptoms include:

• weakness
• fatigue
• rashes on the skin
• arthritis
• protein in urine
• low platelet count

Can I still take my medication?

Most medications commonly taken by Lupus patients are safe to use during pregnancy. Always discuss your options with your doctor as far as treatments, and medications.The medications known as safe during pregnancy (they don't pass into the placenta to harm the baby) are: Medrol (methylprednisolone), Prednisone, and Prednisolone - Aspirin (such as Bayer)

Medications for Lupus that may pass through placenta and harm your baby are:

• Cytoxan (Cyclophosphamide)
• Imuran (azathioprine)
• Plaquenil (hydroxychloroquine)

Harmful but sometimes necessary in cases of underdeveloped lungs in utero are Celestone (betamethasone) and Hexadrol (dexamethasone).

Will I be visiting my doctor often?

Since your pregnancy is classified as a "high risk" pregnancy, you will be asked to come back to see your doctor often for certain tests. Your doctor will monitor your blood pressure incase there are any complications with hypertension or pre-eclampsia. Also, she may need to monitor your urine for any protein. You and your baby will be at risk if you do not see your doctor as requested. Prompt treatment can save your lives.

Anai Rhoads

©1996 Anai Rhoads