At each appointment, your practitioner will perform a series of tests — taking a sample of your blood, a urine sample, listening to your baby’s heartbeat, and asking you about possible lupus symptoms — to determine whether you need any additional treatment. You’ll also get more frequent ultrasounds and be monitored more closely throughout your nine months. If you have particularly high levels of lupus-related antibodies in your blood or have lost a previous pregnancy, for example, daily doses of aspirin and heparin may be prescribed.
Certain medications used to treat lupus (such as hydroxychloroquine/Plaquenil) can be continued during pregnancy. Other medications (such as methotrexate and cyclophosphamide/Cytoxan) aren’t considered safe during pregnancy and should be discontinued before you conceive. Your doctor will help you decide what is best for your health and your baby’s.
If you experience fatigue, soreness or any other symptoms of lupus (hair loss, fever, headaches, swollen joints, anemia, mouth ulcers), it’s better to call your doctor right away than to wait for your next appointment. If you’re further along in pregnancy and you haven’t felt your baby move or feel nauseous or notice swelling — signs of preeclampsia — don’t hesitate to make a trip to the ER. Most importantly, take care yourself — which, like any other pregnant woman, means giving yourself permission to rest if you feel tired.
Also be aware that there does appear to be an increased risk of SLE flare-ups after delivery, so your doctor will continue following you closely. Make sure to go to all your appointments (even though it can be hard with a newborn!) and keep an eye out for flare-up symptoms just as you did during pregnancy.