First Trimester Miscarriages And Lupus
What is Lupus?
Lupus is an autoimmune disease that causes the body's immune system to attack its own cells. Along with a sobering list of symptoms including rashes, fatigue, and inflammation, lupus is also the cause of complications during pregnancy. For a long time, women with lupus were advised not to become pregnant. This is no longer true. Advances in medical science have made it possible for many women with lupus to have completely normal pregnancies.
How is Pregnancy Different for Women with Lupus?
About half of all pregnancies in women with lupus progress normally. Roughly a fourth result in premature delivery, but with no harm to either mother or child. The final fourth of all pregnancies, however, end in miscarriages. In addition, about seven percent of pregnancies in women with lupus result in severe complications for the woman. Women with lupus are much more susceptible to developing serious complications such as diabetes and pre-eclampsia during pregnancies than are those who do not suffer from the disease.
Effects of Pregnancy on Lupus and Vice Versa
Studies on the effects of pregnancy on lupus are contradictory. Some have found that the hormonal changes associated with pregnancy produce more flare-ups of the disease during this time, whereas others have found the exact opposite. Whatever the case may be, flare-ups of the disease during the first trimester have been conclusively linked to spontaneous abortions. In most cases, the direct cause is either the rupture of membranes or complications of pre-eclampsia. Later in the pregnancy, antiphospholipid antibody syndrome (APLS) often causes problems. APLS is caused by the presence of certain abnormal antibodies in about thirty-three percent of women with lupus. These antibodies can cause blood-clots, and if these blood-clots form in the placenta, they can cut off essential nutrients from the developing fetus.
Complications from Medications
An additional complication when dealing with lupus and pregnancy is the need for medications . Most women who suffer from lupus require medication to manage their disease. However, many of the medications commonly used to treat lupus can be lethal to the fetus. Therefore, it is very important that the woman consult her physician before deciding to become pregnant so as to develop a treatment plan that will not endanger the developing fetus or deprive the mother of necessary medicine.
What Can Be Done?
The most important factor of all when considering a pregnancy while dealing with lupus is timing. The best chance for a woman to deliver a healthy baby is to time her pregnancy so as to coincide with a time of optimum health. The healthier a woman is to begin with, the less likely that she will have a flare-up during her pregnancy. Furthermore, as mentioned above, many medications must be discontinued during pregnancy, and this is safest to do if the woman is not currently in need of them. She should always discuss with her doctor before deciding to become pregnant. A woman must also show care in selecting an obstetrician. Ideally, the doctor should have experience in dealing with pregnancies in women with lupus. At a minimum, the obstetrician must be used to dealing with high-risk pregnancies. Equally important is that the obstetrician have access to good facilities for caring for premature newborns, since many women with lupus do not carry to term. Constant monitoring throughout the pregnancy, of both mother and fetus, is also crucial. Early detection can often avert disaster. Certain medications, such as blood-thinners, may decrease the risk posed by APLS.