Lupus During pregnancy

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Dr. Deepinder Kaur (Obstetrician and Gynaecologist)
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Lupus During pregnancy

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Women who have a condition called lupus may have a complicated pregnancy. Lupus is a chronic condition that can affect the health of women who are in their child-bearing age. This condition can increase the risk of miscarriage, preeclampsia, or premature delivery during pregnancy. If you are pregnant with this condition, naturally, you’ll be worried. To learn more about this condition and to know how you can have a safe and healthy pregnancy, read this article!

What Is Lupus?

Lupus is a chronic condition, which occurs due to the malfunctioning of the immune system. This condition usually affects women who are in their child-bearing or reproductive age. However, if you are developing lupus during pregnancy, this does not mean that you will not be able to have a healthy pregnancy and childbirth.

What Are the Causes of Lupus?

There is not much scientific evidence available on what causes lupus. But it is believed that lupus is usually caused due to genetic, hormonal, or environmental causes.

Getting Pregnant With Lupus

If you have this immune malfunctioning disorder, it becomes very important for you to get it in control before you get pregnant because lupus pregnancy could lead to fatal consequences. It is important that you exhibit no symptoms for at least five to six months before you start planning your baby because lupus and pregnancy is a lethal combination and it may lead to miscarriage or other pregnancy-related complications.

What Are the Symptoms of Lupus in Pregnancy?

Here are some commonly observed symptoms of lupus in pregnancy.

  • Painless ulcers in the mouth and nose.
  • A rash after being in the sun for a longer duration. It is also called photosensitive rash.
  • You may have a discoid rash, which is itchy and flaky and mostly appears on the ears and scalp. This may even make you lose some hair.
  • You may develop a butterfly rash that is visible on your cheekbones and on the bridge of your nose.
  • You may experience difficulty in breathing and chest pain.
  • Your fingers may turn blue or pale due to low blood circulation.
  • You may experience joint pains and swelling.

How Common Is Lupus in Pregnant Women?

If you are Asian, African, or Native American, then you are more likely to suffer from lupus than people from other ethnicities. Lupus not only affects women but males too, but the percentage of this condition affecting males is relatively low. It is seen that 1 out of every 250 women, who are in their reproductive prime (14-45 years), is likely to be get affected by lupus.

How Is Lupus Diagnosed?

The symptoms of lupus are very similar to various other diseases. Therefore, in order to reach the correct diagnosis, your doctor may do a lupus anticoagulant test in pregnancy, and other tests may include the following:

  • Blood tests
  • Urine tests
  • A biopsy
  • Physical examination

On the basis of the above-mentioned tests, your doctor will be able to diagnose lupus.

Treatment and Medication

If lupus remains in remission during your entire pregnancy, you may not need any medication for all nine months of pregnancy. However, if your symptoms resurface, then your doctor will administer you medicines that are safe in pregnancy. There is a prescribed course for the treatment of lupus as the symptoms and severity may vary in every case.

You will be closely monitored by your doctor throughout your pregnancy, and you may even have to go through various tests (urine and blood) on each visit. Your doctor will check your baby’s heartbeat, and you may be asked about your symptoms, to decide upon the further course of medication. Here are some commonly used medicines to treat lupus during pregnancy:

  • Hydroxychloroquine/Plaquenil
  • Methotrexate and cyclophosphamide/Cytoxan

However, it is recommended not to take any medicines on your own and always talk to your doctor if you experience any lupus symptoms.

A pregnant woman with swollen foot

How Lupus Affects Pregnancy?

It is observed that women who conceive during the time when lupus is in remission, do better in their pregnancy as compared to women who get pregnant during the flared-up state. There are many risks associated with lupus that may cause complication in pregnancy.

Complications of Pregnancy

Here are some pregnancy complications that may get caused due to lupus:

  • Miscarriage
  • Stillbirth
  • Higher risks of premature or preterm delivery
  • HELLP Syndrome – a rare liver disorder that causes severe blood-clotting
  • Preeclampsia – Lupus can put you at a higher risk of getting affected by it

Effects of Lupus on Unborn Baby

Most mothers with lupus usually deliver healthy babies, but there is no denying that there are risks involved in their pregnancies. However, it is very unlikely that if you have lupus then your baby will have it too. Though the best that you can do to minimise the risks for you and your baby is by conceiving during the quiet period (when the disease is in remission), in case you are in the planning stage. It is suggested to talk to your doctor before you start planning your baby to avoid any complications. If you’re already pregnant, you should speak to your gynaecologist about the same.

How Can Pregnancy Affect Lupus?

Where some women may experience no symptoms of lupus during their entire pregnancy, others may experience mild to moderate symptoms. In some cases, women may experience a complete change in their symptoms or experience reduced symptoms. Every woman may experience different effects of lupus on their pregnancy. However, it is seen women who become pregnant during the quiet period of the disease are less likely to experience any flare-ups during their pregnancy. It is also seen that sometimes women may get confused with lupus and pregnancy symptoms such as pain and aches. It is very important that your report even the mildest symptoms to your doctor to avoid complications.

Can You Prevent Lupus?

Unfortunately, lupus cannot be prevented, but you can take various measures to control your symptoms.

Tips for Safe Pregnancy and Healthy Baby

If you have lupus, it does not mean that you cannot conceive and have a healthy pregnancy. Though women with lupus have high-risk pregnancies, with proper treatment and other measures, they can become pregnant and have a hassle-free pregnancy too.

Before Pregnancy

Here are few things that you should do before your plan to get pregnant:

  • Get in touch with the various set of doctors such as rheumatologist, phrenologist, lupus specialist, paediatric cardiologists, and various other doctors and talk about your risks associated with getting pregnant.
  • Your set of doctors will determine various possible complications that you may face during your pregnancy.
  • Your medication may be changed, or you may get switched over to milder medicines to prepare your body for the upcoming pregnancy.
  • Plan your pregnancy during the period of remission to reduce any further complications and risks.

During Pregnancy

Here are some tips that may come in handy during your pregnancy:

  • Go for regular check-ups and visit your doctor regularly.
  • Do not ignore any signs or symptoms that you may suspect and seek your doctor’s advice at the earliest.
  • It is very important to have adequate rest if you have lupus during pregnancy. Pregnancy exerts pressure on your body and lupus can drain you further.
  • Prepare yourself mentally for various complications that may arise such as, premature delivery.

How Can You Care for Yourself During Pregnancy?

Lupus may strain you; therefore it is very important that you take good care of yourself during pregnancy to feel energized and active. Get ample rest and plan to have a couple of naps during the day and a peaceful night’s sleep.

  • Refrain from consuming alcohol and quit smoking.
  • Make sure you eat a healthy balanced diet to provide your body with adequate nutrition.
  • As soon as you notice any abnormal symptoms that are not pregnancy related, talk to your doctor about the same.

FAQs

Here are some frequently asked questions about the risk of lupus in pregnancy:

1. Can Lupus Patients Have a Successful Pregnancy?

Yes, it is possible for you to have a successful pregnancy. However, it is very important that you learn about when you should get pregnant and also what probable risks you may face during your pregnancy.

2. Can a Mother With Lupus Breastfeed Her Baby?

Yes, you can breastfeed your baby comfortably, even if you have lupus. It may take you a few days to get comfortable with the correct feeding technique. You may ask your nurse or midwife to help you learn about the correct breastfeeding technique.

While lupus cannot be prevented, you can incorporate changes in your lifestyle to keep it under control.

Also Read: Common Pregnancy Problems

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