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Pregnancy and Lupus

(continued)

Managing Problems of Pregnancy continued...

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:

  • Backache
  • 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.

Caring for Yourself During Pregnancy

In addition to seeing your doctor regularly and following your treatment plan, there are many things you can do to care for yourself and your baby:

  • Get plenty of rest. Plan for a good night's sleep and take breaks throughout the day.
  • Eat healthfully. Avoid excessive weight gain. Have your doctor refer you to a dietitian if needed.
  • Avoid smoking and drinking alcohol.
  • If you have any unusual symptoms, speak to your doctor right away.

Managing Delivery and a New Baby

Your doctor will decide the method of delivery -- caesarian section or vaginal. He'll do this by taking into account your health and your baby's health at the time of labor. Many women with lupus can have vaginal deliveries. But if the mother or baby is under stress, a caesarean section may be the safest and fastest way to deliver. If you have taken steroids during pregnancy, your doctor will increase your dose during labor to help your body cope with the added stress.

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