Lupus in pregnancy

Systemic lupus erythematosus (SLE) during pregnancy, a high-risk situation.

The high risks are to both the mother and child.

Women with SLE can have flares of SLE during pregnancy.

There is also a markedly increased risk of a miscarriage (spontaneous abortion).

The presence of phospholipid antibodies, such as cardiolipin antibodies or lupus anticoagulant, in the blood of the mother can identify a high risk for miscarriage.

Cardiolipin antibodies are associated with a tendency toward blood clotting.

Women with SLE who have cardiolipin antibodies or lupus anticoagulant may need blood thinning medications (aspirin with or without heparin) during pregnancy to prevent miscarriages.

IV gamma globulin may be useful for selected patients with a history of miscarriage and those with low platelets during pregnancy.

Pregnant SLE women who have had a previous blood clotting event may benefit by continuation of blood thinning throughout and after pregnancy for up to 6-12 weeks, at which time the risk of clotting associated with pregnancy seems to diminish.

Plaquenil appears safe for use to treat SLE during pregnancy.

See also: Neonatal lupus.