02-22-2007, 06:53 PM
I haven't posted in awhile. I hope everyone is keeping warm. Our arctic weather is finally starting to break a little.
Well - I am just wondering if anyone has any advice on pregnancy with lupus. I think I developed Lupus after my second pregnancy. I would really like another baby and my husband even more so....I had alot of nausea and felt unwell during the first two but no obvious joint pain so I don't think things had really developed yet. I know about the published risks and my disease is very active but I am essentially on prednisone to control it. I don't seem to have any kidney or blood problems now. I am recovered from heart valve surgery so I am thinking this is the window.
Does anyone have any advice on things to ask the doctors when looking for the green light? I know antiphopholipids are important to look at - mine are postive but a low positive apparently. I am meeting with 3 doctors in the next month so am hoping for some good insight.
02-23-2007, 11:37 AM
Most doctors say that pregnancy, itself, has little effect on Lupus. The issue is "what effect does lupus have on pregnancy"?
You may have worsening kidney function as a direct result of pregnancy and many women find that lupus flares (sudden increases in disease activity) are more common during pregnancy and post partum. Some complications of pregnancy can include high blood pressure, stroke, preeclampsia, diabetes, and pre-term delivery, among others.
It is generally held that pregnancy is pretty routine with Lupus patients until the third trimester. At that point, weekly assessment of the mother and fetus is necessary in order to assure that maternal and fetal well-being are maintained. It is very rare (almost never) that doctors can asses specific effects of lupus on the fetus. However, if some are found or diagnosed, these effects can result in the need for a cardiac pacemaker in the newborn child and other manifestations of transient lupus. It does not appear however that lupus is genetically transmitted in the traditional sense, that is to say, it is not considered to be a hereditary disorder.
Everyone agrees that, with Lupus, the best time to get pregnant is when you are at your healthiest..so I think your timing is good. Women in lupus remission have much less trouble than do women with active disease. Their babies do much better, and everyone worries less.
With reference to your medications: Most medications commonly taken by those with SLE do not get through the placenta and are safe for the baby:
such as, prednisone, prednisolone, and probably methylprednisolone (Medrol). But others do reach the baby and are used ONLY when it is necessary to treat the baby as well. For example, these medications might be used to help the lungs mature more rapidly if the baby will be premature: dexamethasone (Decadrol, Hexadrol), betamethasone (Celestone), A small dose of aspirin is safe and is often used to protect against toxemia.
Preliminary reports suggest that azathioprine (Imuran) and hydroxychloroquine (Plaquenil) do not harm babies, but the final word is not yet in on these: Cyclophosphamide (Cytoxan) is definitely harmful if taken during the first three months of pregnancy!
With reference to your heart: Women with a history of heart disease are likely to experience pregnancy complications. Being pregnant necessarily changes your heart and blood vessels as your body adapts to the needs of being pregnant. As pregnancy progresses, blood pressure decreases as the amount of blood in the body increases to accommodate both mother and growing fetus. The strain from these changes, in combination with pre-existing heart problems, can lead to serious symptoms such as shortness of breath, headache, loss of concentration, fatigue, and chest pain. If you have been medicated for your heart disease prior to becoming pregnant, you will want to work with your doctor to make sure your medicines are safe to use during pregnancy. Additionally, the extra strain on the heart and circulatory system caused by being pregnant can be minimized by taking steps to reduce anxiety and stress, resting, avoiding strenuous activity and heat, taking iron supplements to prevent anemia (decreased ability of the blood to carry oxygen), and by becoming aware of the signs of heart failure (which include breathing difficulties, tiredness, and coughing fits). The strain of pregnancy can also cause heart problems such as heart murmurs, arrhythmias, and high blood pressure to develop even when such problems were not previously apparent. Heart murmurs and arrhythmias are complications of pregnancy which do not generally require treatment. However, high blood pressure needs to be taken seriously because it may indicate the onset of pre-eclampsia, a condition requiring immediate medical attention.
Perhaps someone else will also have some suggestions for you and some information that you should be aware of.
I wish you the best, including a happy and healthy baby!!
Peace and Blessings
02-23-2007, 12:52 PM
Thanks as always for an informative and caring post. Excellent to know. I will keep you posted.
All the best Karen
02-23-2007, 01:03 PM
I hope that you manage to sort everything out with your doctors!
Let us know how it goes!
I will pray that you will have a very happy, beautiful and healthy baby and I'm sure that you will! :)
Just remember to take care of yourself! :)
Keep well and God bless! :)