LUPUS FLARE DURING PREGNANCY

Systemic lupus erythematosus (SLE) is a complex autoimmune disease that predominantly affects women of fertile age. Women with systemic lupus erythematosus (SLE) face significant risks when embarking on a pregnancy, but attending a multidisciplinary clinic staffed by an experienced team can improve pregnancy outcome for women and their babies. Queries regarding the risk of disease flares during pregnancy, chance of fetal loss, and the safety of various drugs are often raised. With the improvement in the understanding of the pathogenesis of SLE and the judicious use of immunosuppressive drugs, better disease control can now be achieved and SLE patients should not be deprived of the opportunity for bearing children. The aim of this study was to examine the pregnancy outcomes in patients with systemic lupus erythematosus (SLE) and the effect of SLE flare and treatment on pregnancy outcomes. In this review, important issues regarding the fertility rate, risk of disease flares during lupus pregnancy, pregnancy course, fetal outcome, safety of various drugs used for disease control during pregnancy and lactation, and contraceptive advice are discussed. Hydroxychloroquine, pulse intravenous methylprednisolone and azathioprine are safe to treat lupus flares during pregnancy. Appropriate individual based advice was given to couples during pre-pregnancy counseling.