SLE and pregnancy

Abstract

In patients with SLE in remission pregnancy does not confer a special risk to either the mother or foetus, and immunoregulatory drugs should not be withdrawn prior to a pregnancy where these are required for disease control. Likewise therapy to treat disease flares during pregnancy should not be withheld as the foetus is at comparitively more risk from the effects of the maternal disease than from the small risk associated with therapy. Patients with active disease should be counselled against pregnancy but therapeutic abortion in such patients is only very rarely indicated. High risk groups benefit from close monitoring though the previous obstetric history will not necessarily reflect outcome in subsequent pregnancies. Patients without a previous obstetric history should not be treated prophylactically due to the detection of antiphospholipid antibodies, and the optimum treatment for those with poor histories and aPL is currently being investigated.