Pregnancy and Lupus
Managing Problems of Pregnancy continued...
Flares. Some women report improvement of lupus symptoms during pregnancy. But flares during pregnancy occur in up to 30% of women. Periods of increased disease activity occur more often during the first few months after delivery. Research suggests that waiting to get pregnant until your disease has been controlled for at least six months reduces your risk of a flare during pregnancy. Most flares, when they do occur, are mild. Your doctor can often treat them with low doses of corticosteroids.
Hypertensive complications. Complications involving high blood pressure can affect up to 20% of pregnant women who have lupus. High blood pressure can be brought on by pregnancy. High blood pressure can also increase your risk of preeclampsia. This is a serious condition in which there is a sudden increase in blood pressure or protein in the urine or both. It occurs in about one out of every five lupus pregnancies. Preeclampsia requires immediate treatment and often delivery of the baby. It is more common in women with kidney disease or high blood pressure and women who smoke.
Miscarriage. Approximately one out of every five lupus pregnancies ends in miscarriage. Miscarriages are more likely in women with high blood pressure, active lupus, and active kidney disease. Miscarriage can also be the result of antiphospholipid antibodies. These are a type of antibody that increases the tendency to form blood clots in the veins and arteries. That includes those in the placenta. For this reason, it is important to screen for the antibodies. It's especially important for women who have miscarried before. If the antibodies are found, your doctor may prescribe a blood thinner. That will help prevent the formation of clots. With the use of such medications, about 80% of the women will not miscarry.
Preterm delivery. About one out of every three women with lupus delivers preterm. That means before completing 37 weeks of pregnancy. This is more likely in women with preeclampsia, antiphospholipid antibodies, and active lupus. It's important to know the symptoms of premature labor, which may include:
- Pelvic pressure
- Leakage of blood or clear fluid from the vagina
- Abdominal cramps
- Contractions occurring every 10 minutes or more
Let your doctor know right away if you experience any of these symptoms.
Women with lupus may have a greater risk of pregnancy complications. They do not, though, have greater chance of having a baby with a birth defect or mental retardation compared to women without lupus.