Preconception management
:
1. Assess disease activity from history, examinations and investigations
2. Risk assessment by checking for antiphospholipid antibodies (for a risk of fetal loss) and for anti-Ro and anti-La antibodies (for a risk of neonatal lupus) should be performed before pregnancy.
3. If active disease, advise to defer pregnancy and continue effective contraception
4. Discuss effect of SLE on pregnancy management and outcome.
5. Women with anti-phospholipid antibody syndrome will require more frequent monitoring than those with SLE alone
6. Discuss effect of pregnancy on SLE
7. Discuss terratogenic effects of drugs such as methotrexate, cyclophosphamide and mycophenolate.
Due to long half-lives, these drugs should be stopped at least 3 months before the planned conception.
8. Women should use contraception while on immunosuppressive disease-modifying drugs such as mycophenolate and cyclophosphamide.
Cyclophosphamide is absolutely contraindicated during pregnancy.
9. Discuss drugs that need to be stopped as soon as pregnancy is detected, such as warfarin.
10. Discuss general measures including folic acid supplementation, screening for rubella immunity
1. Assess disease activity from history, examinations and investigations
2. Risk assessment by checking for antiphospholipid antibodies (for a risk of fetal loss) and for anti-Ro and anti-La antibodies (for a risk of neonatal lupus) should be performed before pregnancy.
3. If active disease, advise to defer pregnancy and continue effective contraception
4. Discuss effect of SLE on pregnancy management and outcome.
5. Women with anti-phospholipid antibody syndrome will require more frequent monitoring than those with SLE alone
6. Discuss effect of pregnancy on SLE
7. Discuss terratogenic effects of drugs such as methotrexate, cyclophosphamide and mycophenolate.
Due to long half-lives, these drugs should be stopped at least 3 months before the planned conception.
8. Women should use contraception while on immunosuppressive disease-modifying drugs such as mycophenolate and cyclophosphamide.
Cyclophosphamide is absolutely contraindicated during pregnancy.
9. Discuss drugs that need to be stopped as soon as pregnancy is detected, such as warfarin.
10. Discuss general measures including folic acid supplementation, screening for rubella immunity
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