women s health issues
Autoimmune Disorders During Pregnancy
Systemic Lupus Erythematosus (Lupus)
 Systemic Lupus Erythematosus (SLE) may appear for the first time, worsen, or become less severe during pregnancy. How a pregnancy affects the course of lupus cannot be predicted, but the most common time for flare-ups is immediately after delivery. Women who develop lupus often have a history of repeated miscarriages, fetuses that do not grow as much as expected ( Small-for-Gestational-Age (SGA) Newborns ), and Problems related to lupus can be minimized if the following are done: Women wait to become pregnant until the disorder has been inactive for 6 months. The medications have been adjusted to control lupus as well as possible. Blood pressure and kidney function are normal. In pregnant women, lupus antibodies may cross the placenta to the fetus. As a result, the fetus may have a very slow heart rate, anemia, a low platelet count, or a low white blood cell count. However, these antibodies gradually disappear over several weeks after the baby is born, and the problems they cause resolve except for the slow heart rate. If women with lupus were takinghydroxychloroquinebefore they became pregnant, they may take it throughout pregnancy. If flare-ups occur, women may need to take a low dose ofprednisone(a corticosteroid) by mouth, another corticosteroid such asmethylprednisolonegiven intravenously, or a medication that suppresses the immune system (immunosuppressant) such asazathioprine. 