Systemic lupus erythematosus is a chronic multi-organ system autoimmune disease that predominantly affects young women of childbearing age. Pregnancy increases the disease flare-up by rates of 25-65%. These flares increase the risk of preterm birth, miscarriage, intrauterine growth restriction, infections, and fetal heart block. Although lupus is a high risk for negative pregnancy outcomes, disease management, and pregnancy outcomes have improved considerably over the past years.
The disease and symptoms differ from one patient to another.
Fever
Fatigue
Weight loss
Sensitivity to light
Butterfly-shaped rash
Alopecia
Joint pain
Joint stiffness
Mouth ulcers
Shortness of breath
Cough
Nausea and vomiting
Abdominal pain
Visit a Rheumatologist if you have any of these symptoms for proper diagnosis, or for getting the proper treatment if you were already diagnosed and you are pregnant or planning for pregnancy now, and keep your Gynaecologist updated during follow-up visits
The cause of the disease is still unknown, but it is thought that genetic, environmental, hormonal, and immunological factors play a role in disease development.
The diagnosis is done by a Rheumatologist through specific diagnostic criteria that include the symptoms in addition to laboratory tests such as:
Antinuclear antibodies (ANA)
Systemic lupus erythematosus-specific antibodies
Kidney functions
The patient should be managed by a multi-disciplinary team that includes a Rheumatologist, Maternal-fetal medicine specialist, Nephrologist, and Pediatric cardiologist. Many medications can be used and chosen according to the case and the stage of pregnancy such as:
Hydroxychloroquine sulphate
Azathioprine
Colchicine
Prednisone
Cyclosporine
Tacrolimus
Ibuprofen
Acetylsalicylic acid (Aspirin)
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