How to Treat Lupus if You're Pregnant
Of course, it is best not to take any sort of drug while pregnant, but a woman's lupus should not go untreated if she is pregnant. In fact, a lupus flare may be worse for the baby than a drug to treat it. Aspirin and prednisone are both considered safe during pregnancy, while there is debate as to the safety of other drugs. Cyclophosphamide (Cytoxan) should not be used due to the danger of fetal malformations and miscarriages.
There are two types of required monitoring for pregnant lupus patients: monitoring the mom and the baby. At the beginning of the pregnancy, all standard lupus tests are conducted, and antiphospholipid antibody, anti-Ro/SSA, and anti-La/SSB antibody levels are determined to ensure that the mother is healthy. Throughout the pregnancy there is also frequent monitoring of urine and blood for signs of lupus, especially red blood cell count, platelet count and urine protein.
The fetus is checked using ultrasound tests and its growth is monitored. At about twenty-five weeks (six months), a series of tests for the baby's general health begin. None of these tests are invasive, painful, or dangerous to the mother or baby. Depending on the situation, they might be done one time only, or they might be done weekly or daily.
Lupus and Baby
There are no specific genetic risks for babies born to mothers with lupus, nor is there worry of slower intellectual development than the average child. There is however, a risk of miscarriage and premature birth, but careful monitoring can lower the risks.
Approximately one third of babies born to women with lupus contract neonatal lupus, but this is not serious and it consists mostly of a rash brought on by sun exposure that will go away on its own.
A rare manifestation of neonatal lupus, called heart block, is more serious and causes a slower than normal heartbeat in the unborn baby. However, this cannot be treated before birth, and the baby's general health is closely monitored throughout the pregnancy. After birth, the baby may need a pacemaker. Heart block will occur in less than one percent of babies born to mothers with lupus.