Systemic Lupus Erythematosus and Pregnancy

I. Effect of pregnancy on Systemic Lupus Erythematosus
For many women who have had Systemic Lupus Erythematosus, it has been troubled them if they want to have a baby, whether pregnancy will lead to the relapse of this disease.
Actually, there is still not a definite conclusion about it. However, through a series of studies, it is found that if this disease relapses in pregnancy, the patients' condition will not be more serious than that in normal cases. For those whose condition is mild, and has been controlled well, the recurrence rate is low. In a word, for women with Systemic Lupus Erythematosus, they should follow the guidance of their doctors during the whole process of pregnancy.
II. Permitted conditions of pregnancy for women with Systemic Lupus Erythematosus
It is indicated by studies that the active state of this disease is the important risk factor which can determine the relapse in pregnancy. In female patients with Lupus Nephritis, the recurrence rate in pregnancy is 7.4%~63%. The best time for female patients to get pregnant is 6~12 months after their condition has been controlled.
It is indicated by studies that in the following conditions, the adverse effect of pregnancy will decrease:
1. There are no serious heart or kidney involvement, abnormalities of the blood system, nervous system damage and liver damage
2. The remission period should last at least for one year
3. The renal function is normal, and the creatinine clearance rate should be maintained at 60%~80%
4. The maintenance dose of prednisone should be less than 15 mg/d, and immunosuppressant is not adopted
5. Those whose immune monitoring index increases are not appropriate to get pregnant, such as antinuclear antibody titers, anti-DNA antibodies, immunoglobulin quantitation, etc.
III. Suggestion for terminating and continuing the pregnancy
For those who are not appropriate for pregnancy, contraception measures are necessary. And if they get unplanned pregnancy, it should be terminated in the early stage, for more late the operation is done, more higher the risk will be.
For pregnant women with Systemic Lupus Erythematosus who do not receive treatment, large doses of glucocorticoid should be adopted to control the condition before receiving the abortion.
For those who can get pregnant, they should return visit their doctors regularly, and pay attention to monitor the complications of pregnancy. And the monitoring items include blood pressure, the condition of the unborn baby, blood and urine routine test, liver function, renal function and the aforementioned immune monitoring index. In addition, they should be hospitalized one month before the expected date of childbirth.