lupus and pregnancyLupus, or systemic lupus erythematosus (SLE), is a disorder that affects how the body’s immune system reacts to the skin, heart, lungs, joints and brain and various other organs. The immune system attacks the body leading to a constant state of inflammation. There is no known cause for the condition.

Symptoms

Symptoms of lupus vary based on the severity of the condition. Some patients exhibit mild symptoms like skin rash and painful joints. More severe cases of lupus present with severe joint pain, immobility and impairment of life-sustaining organs like the heart, lungs and brain. Common symptoms include:

  • Fatigue
  • Fever of unknown origin
  • Loss of hair
  • Sores in the mouth
  • Light sensitivity
  • Skin rash
  • Swelling of the lymph nodes

Some patients experience symptoms in just one or two body systems, like joints or skin, but other patients experience multi-system symptoms.

Treatment

Lupus has no cure so patients are treated to reduce symptom severity and prolong life. Common treatments for mild lupus include NSAIDS (nonsteroidal anti-inflammatory) and corticosteroid cream to treat skin symptoms. More severe forms of lupus may require oral corticosteroids and drugs to stop cell growth.

Prognosis

The expected life-span for someone with lupus depends on the severity of the disease. Mild lupus may not affect life-span, but more severe cases may cause life-threatening complications like deep vein thrombosis, pulmonary embolism, hemolytic anemia or stroke. Severe lupus may shorten life-span if treatment does not successfully prevent damage to vital organs.

Trying to Conceive

Women with lupus are just as likely to conceive as healthy women. It is best to plan attempts at pregnancy during a time when symptoms are under control. Talk with your physician about your desire to become pregnant before attempting conception as some lupus medications are not safe for use during pregnancy.

Pregnancy

The biggest issue with lupus in pregnancy is medication use. Medications like Decadron, Celestone and Hexadrol pass through the placenta and reach baby. These medications are all in pregnancy category C, as placed by the Food and Drug Administration. This category is reserved for drugs that may or may not have an impact on the fetus. Safe alternatives, including corticosteroids like prednisone, are considered safe alternatives for lupus treatment during pregnancy.

There is an increased risk of early delivery in patients with Lupus. Your doctor will watch your pregnancy and fetus closely for signs of early labor and fetal size/development.

Breastfeeding

There is no reason why a woman with lupus cannot breastfeed, but there are certain medications that pass to baby in breast milk. Talk with your doctor or the pediatrician about the medications you are currently taking or when your medications change.

Preterm delivery could cause trouble breastfeeding if baby is small. Patients can work with a lactation consultant on proper breastfeeding techniques in this situation.

Flare-ups are also a concern. Pregnancy may cause an increase in symptoms that extend postpartum. Some women choose to pump breast milk for bottle feeding so they can continue feeding baby with breast milk when flare-ups make breastfeeding difficult.