Pregnancy and Lupus Nephritis
Has anyone ever had lupus nephritis or healing from it and gotten pregnant or heard of anyone in this situation? If so, how was your/their pregnancy?
I have tried to ask the same question of posters here. You could do a search for the post. A couple people wrote back, but there don't seem to be too many with nephritis.
thanks- hopefully we'll get more info this go round
If Lupus Nephritis is diagnosed, adequately treated and followed carefully, pregnancy in lupus nephritis women can take place without major complications and can have a successful outcome. There are some things to consider, however.
Did you have Lupus Nephritis prior to conception or did it appear after conception? For many women with Lupus, nephritis appears during their pregnancy and, if this is the case, their Lupus is usually severe. I don't know too much about pregnancy and Lupus nephritis and I don't want what I do know to scare you. It is generally thought that pregnancy exacerbates Lupus Nephritis. This exacerbation during pregnancy may be wide-ranging, causing increased proteinuria and leading to renal failure. Pre-eclampsia with hypertension and proteinuria is sometimes mistaken for the flare of lupus. Very severe exacerbation of lupus in pregnancy may require termination of the pregnancy. It is generally accepted that if exacerbation requires termination, the disease will not necessarily improve, but it is unlikely to become worse.
Pregnancies with women with Lupus nephritis are also marked by an increase in fetal loss (miscarriage) and increased fetal morbidity. Since IgG antibodies cross the placenta, there is a risk of lupus in the new-born. These manifestations of lupus disappear in 3-6 months. Some babies have congenital heart block associated with anti-SSA antibodies in the maternal serum and the baby's heart lesions may be permanent.
Therefore, women with Lupus Nephritis are strongly encouraged to wait until their lupus has been in remission for six months before becoming pregnant. Also, here is a list of other precautions that are suggested:
1. Drugs that may be frequently used in non-pregnant women such as cyclohosphamide, methotrexate, warfarin and andiotensin converting enzyme inhibitor type drugs should be switched to another drug with an analogous effect.
2. Blood pressure should be well controlled.
3. Regular, frequent (1-4 times/month) follow ups are advised. Foetal status should be closely monitored.
4. Urine analysis, urea and creatinine, lupus serology, serum urate, platelet count and C3 and C4 levels should be checked especially in pregnant women with proteinuria.
5. Flares of lupus nephritis during pregnancy should be treated with steroids and azathiaprine. Steroids, azathiaprine, methyldopa and diuretics are safe in pregnancy.
6. Continuation of immunosuppressive treatment for at least 2 months after delivery is advised. Activity of lupus is frequently related to prolactin level, and as high levels of prolactin are found in lactating mothers, this may play a role in postpartum flares of lupus.
I hope that I have not caused you great alarm. I wish you the very best and hopefully, someone will have personal experience to share with you!
Peace and Blessings