Systemic Lupus Erythematosus (SLE) and Pregnancy

Posted On Apr 28, 2022

Dr. Abhishek Patil

Consultant - Rheumatology

Manipal Hospitals-Old airport Road, Bengaluru

Gynae Hospital in Bangalore

Introduction

Every mother-to-be wants a healthy pregnancy and so does a woman with lupus. Systemic Lupus Erythematosus (SLE) is a condition that typically appears during the childbearing years in women. Lupus can affect pregnancy; however, most pregnancies go on smoothly even with lupus. 

What is Systemic Lupus Erythematosus (SLE)?

Systemic Lupus Erythematosus (SLE) is a common autoimmune disorder that affects women. Your body’s immune system identifies foreign bodies like viruses and bacteria and attacks them to ensure that you are healthy. An autoimmune disorder is a condition where your body’s immune system starts attacking its own cells. Your immune system mistakes all your healthy cells to be dangerous and thereby attacks them.

Hence, if you are trying to get pregnant, it is essential that you manage your SLE symptoms and then start trying. SLE increases your risk of intrauterine fetal death, spontaneous abortion, intrauterine growth retardation, preeclampsia, and preterm birth. 

Systemic Lupus Erythematosus (SLE) & Pregnancy

You can get pregnant with lupus, but your risk of developing certain complications increases during pregnancy. Consult your doctor if you have SLE and you wish to get pregnant. 

Before Getting Pregnant:

  • Consult our doctor for 3 to 6 months before you start trying to conceive. 

  • You can plan for a safe pregnancy and understand all your risks.

  • Your physician may need to change your medicines for SLE around 3 to 6 months before you start trying to get pregnant. 

  • Planning helps manage your condition better and lowers your risks during pregnancy. 

  • Start trying when your SLE symptoms are minimal and under control. 

  • If you do not wish to get pregnant, opt for birth control to prevent an unplanned pregnancy.

After Getting Pregnant:

  • A physician who specializes in maternal-fetal medicine will be able to manage your case. Your regular doctor and your rheumatologist will help you manage your symptoms and stay healthy during your pregnancy.

  • Go for regular follow-ups and ensure that you get your tests done routinely.

  • Consult your doctors for any queries or new symptoms that may arise during your pregnancy.

  • Opt for your delivery in a hospital that has a neonatal intensive care unit (NICU). This will help if your baby develops any complications after birth.

Post-delivery

  • Some patients develop HELLP syndrome or preeclampsia after giving birth. Although rare, it is a possibility, and you need to be careful.

  • Inform your physician about your complaints and schedule an appointment right away. 

  • Regular follow up every 2-3 months after your baby is born is a must.

  • Your doctor may change your SLE medicines or start some medicines that were stopped during your pregnancy.

What are the complications during pregnancy with systemic lupus erythematosus (SLE)?

While most women with systemic lupus erythematosus (SLE) have healthy pregnancies, lupus dose increases your risk of developing serious complications. 

  • Blood clots

  • High blood pressure leads to a serious condition called preeclampsia

  • Kidney disorders

  • Premature birth 

  • Growth problems where the baby is growing slowly in the womb

  • Miscarriage - loss of pregnancy before the 20th-week mark

  • Stillbirth - loss of pregnancy after the 20th-week mark

  • Delivering a baby with heart blocks or neonatal lupus

When should you delay your pregnancy with systemic lupus erythematosus (SLE)?

Although most pregnancies with lupus are healthy, some women may have to delay their pregnancy. You may have to plan with your physician and alter your time of getting pregnant in the following scenarios:

  • If your lupus is active

  • If you have kidney disease

  • If you have had a miscarriage in the past

  • If you have had thrombosis in the past

  • If you are on medicines like methotrexate, cyclophosphamide, or mycophenolate

Will Your Baby Be Born With Systemic Lupus Erythematosus (SLE)?

Not always. Some babies may develop a condition known as neonatal lupus. It is a different type of systemic lupus erythematosus that is seen only in babies. It is not necessary that these babies may develop lupus when they grow up to become adults. 

Babies with neonatal lupus will have a rash on their faces. This rash goes away within 6 months post-birth. Rarely, these babies with neonatal lupus may develop congenital heart blocks that are identified during pregnancy. Such babies need immediate care post-delivery and may require a pacemaker in their heart to control their heartbeat. 

If you are looking for SLE (Systemic Lupus Erythematosus) treatment in Bangalore then visit Manipal Hospital and consult with one of the best rheumatologst in Bangalore experienced and trained in diagnosing and treating common to rare rheumatology conditions.

 

Dr. Abhishek Patil

Consultant - Rheumatology

Manipal Hospital, Old Airport Road, Bangalore
 

 

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