Chapter

Lupus nephritis and pregnancy

Kate Bramham, Sarah Germain and Catherine Nelson-Piercy

in Lupus Nephritis

Second edition

Published on behalf of Oxford University Press

Published in print November 2010 | ISBN: 9780199568055
Published online November 2012 | e-ISBN: 9780191753374 | DOI: http://dx.doi.org/10.1093/med/9780199568055.003.0011

Series: Oxford Clinical Nephrology Series

Lupus nephritis and pregnancy

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Women with lupus nephritis tend to have complicated pregnancies, with increased rates of pre-eclampsia, fetal loss, pre-term delivery, low birth weight infants, and neonatal complications. However, risks are significantly reduced in those with inactive disease at conception, and in the absence of hypertension, renal impairment, and APL antibodies. Renal disease flare does not appear to be increased by pregnancy, but may be difficult to distinguish from pre-eclampsia.

Pre-pregnancy counseling is advised for women to make an informed decision about risks and potential complications associated with pregnancy. Immunosuppression needs to be reviewed, together with other medications such as analgesia and antihypertensives. Careful assessment for complicating factors, including anti-Ro and anti-La antibodies, APL antibodies, and the presence of hypertension, proteinuria, and pulmonary hypertension, is important. Antenatal care should be delivered by a multi-disciplinary team with expertise in the care of women with SLE and renal disease. Surveillance for disease flare and pregnancy complications is essential.

Chapter.  10342 words. 

Subjects: Nephrology ; Obstetrics

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