Make no mistake, an expecting woman who has Lupus (a Rheumatic Disease) will be a high-risk pregnancy. That’s why it is critical and essential to rely on the expertise of Dr. Steve Rad, a Los Angeles-based OBGYN who specializes in high-risk pregnancies.
Though there are several higher risks with a lupus pregnancy, including preterm delivery, modern medicine has made having a normal birth possible.
Dr. Rad often teams with a pregnant patient’s rheumatologists to help manage the Lupus pregnancy risks so our patients can have healthy pregnancy outcomes.
There are four kinds of lupus, but the most common one is called systemic lupus erythematosus (SLE). So, generally, when lupus is mentioned, it is SLE.
While medical professionals do not know the exact cause of Lupus, autoimmune diseases do tend to run in families. It is also believed that Lupus can develop as a reaction to certain hormones, including estrogen.
Lupus symptoms that can cause difficult pregnancies include:
Severe exhaustion
Photosensitivity
Infection
An inordinate amount of stress on the body
Emotional distress
Important blood tests for lupus patients
Dr. Rad often gives lupus patients a simple blood test that can identify biomarkers that indicate whether a patient will have a normal pregnancy or if they’re at risk for problems.
According to John Hopkins University, every woman with lupus should be screened for antiphospholipid antibodies — both the lupus anticoagulant and anticardiolipin antibody.
A pregnant person with lupus will undergo monthly testing for blood count, creatine, and liver function, as well as urinalysis and 24-hour urine collection to analyze proteins and kidney function.
Lupus flare-ups and pregnancy
A lupus flare-up is the greatest risk for a pregnant woman. A pregnancy that occurs when your lupus is active can result in miscarriage or stillbirth.
A good rule of thumb is to time your pregnancy with a period of good disease control. Do not discontinue lupus medication simply because you are trying to become pregnant — that may cause a flare-up. Try to time your pregnancy after you have had low disease activity for six months — talk to your high-risk pregnancy specialist to calculate the right time to start trying for a pregnancy.
Scientists have found that the hormone prolactin, which rises during pregnancy, can cause lupus to flare. Research shows that pregnant women experience renal and hematologic outbreaks and fewer arthritis flares, according to the Johns Hopkins Lupus Center.
Lupus pregnancy complications
Pregnant women with lupus are at higher risk for a variety of complications. These include:
Preeclampsia and lupus
The leading cause of preterm birth in women with lupus, preeclampsia is persistently high blood pressure during pregnancy or the postpartum period.
High blood pressure during the second trimester of pregnancy is one indicator that the mother may have preeclampsia. This can cause a decrease in platelets as well as trouble with the kidneys, liver, lung fluid, or seizures.
Common preeclampsia symptoms include headaches, abdominal pain, shortness of breath, burning behind the sternum, nausea, confusion, anxiety, and visual disturbances. Preeclampsia impacts 5-8% of all pregnancies in the United States, according to the Preeclampsia Foundation.
Pregnant people have few options when diagnosed with preeclampsia. The best option is to rest until delivery. If aggressively treated with blood pressure medication, there is a risk of reducing blood flow to the placenta.
Call (844) 473-6100 or click here to schedule online
Antiphospholipid antibodies
If you test positive for antiphospholipid antibodies — both the lupus anticoagulant and anticardiolipin — your baby is at risk for congenital heart block. When a pregnant person tests positive, we closely monitor the fetus’s cardiac system using an echocardiogram.
Lupus nephritis pregnancy
Lupus nephritis — when lupus autoantibodies affect the kidneys — does not lead to worsened pregnancy or fetal outcomes. However, active renal disease — kidney disease — is associated with pregnancy-induced hypertension, as well as flares of lupus activity during pregnancy.
Diabetes
It is widely known that gestational diabetes mellitus (GDM) is a common pregnancy complication for those with lupus. GDM is defined as impaired glucose tolerance first noticed during pregnancy and is associated with negative maternal and fetal outcomes. Moreover, GDM also increases the risk of post-partum diabetes and heart disease.
Urinary tract infections
Urinary tract infections (UTI) are common in immunocompromised patients. Patients with SLE, therefore, have an increased risk of an infection, usually caused by E coli.Lupus nephritis is also thought to be a risk factor in developing a UTI, often necessitating hospitalization.
Lupus medication and pregnancy
It is critically important to have a doctor review your current medications when planning your pregnancy. A pregnancy that occurs when you are taking a toxic medication for Lupus can lead to miscarriage or stillbirth. It can also lead to birth defects and/or very early delivery — which can have life-long consequences for the child.
Keep in mind that some lupus medicines remain in your bloodstream for several months after you stop taking them. Discuss with Dr. Rad if you should discontinue or switch potentially harmful medicines at least three months before trying to get pregnant.
Always talk to a healthcare provider before quitting or altering any prescription medications. Improperly changing medications can have serious side effects.
Some medications that will need to be discontinued or adjusted include:
Prednisone
If a pregnant woman with Lupus is taking the drug prednisone — a powerful anti-inflammatory corticosteroid — she may develop diabetes and hypertension. If corticosteroids are indicated, we will probably lower the dose.
Cyclophosphamide
Cyclophosphamide is a drug used to suppress the immune system. It should always be discontinued during pregnancy because it may cause birth defects.
Coumadin
Some patients with lupus experience blood clots during pregnancy. The blood thinner Coumadin should be switched during pregnancy because it may harm the fetus’ kidneys. Anti-clotting medications, such as low-dose aspirin, may be an option for women with lupus anticoagulants.
Plaquenil
Plaquenil (hydroxychloroquine), a malaria drug used to treat lupus and rheumatoid arthritis, may usually be taken during pregnancy. It should, however, be discontinued during breastfeeding.
Methotrexate
Methotrexate is a cancer drug used to treat lupus. It’s almost always discontinued during pregnancy because it can cause birth defects.
Successful pregnancy with lupus
The key to success with lupus in pregnancy is a strong, trusting relationship with your doctor. This connection begins when you are planning a pregnancy, maybe as early as six months before you try to conceive.
Stay positive! With an optimistic outlook and the guidance of Dr. Rad, you have an excellent chance of meeting the challenge of a pregnancy with lupus.
Why choose Dr. Steve Rad and the Los Angeles Fetal and Maternal Care Center
Did you know that all pregnancies in the United States are at risk of becoming high-risk? Even a pregnancy that begins “low-risk” can become high-risk. That is no secret to double-board certified Dr. Steve Rad, an Obstetrician-Gynecologist with sub-specialty training in Maternal-Fetal Medicine / Perinatology.
Dr. Rad has been named a top Maternal-Fetal Medicine specialist in Los Angeles by Los Angeles Magazine for six years in a row.
We are conveniently located for patients throughout Southern California and the Los Angeles area at locations in or near Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, Newport Beach, Irvine, and Downtown Los Angeles. We also offer in-home prenatal care and a fly-in program for out-of-town and international patients. Dr. Rad even travels to patients who need him throughout the U.S. and around the world.
If you can’t make it to Dr. Rad, he also offers virtual consultations worldwide.
Call (844) 473-6100 or click here to schedule online
Can women with lupus have children?
Yes, women with lupus can have children, but it’s crucial for them to coordinate closely with their healthcare team. Lupus varies in its impact on pregnancy, with some experiencing flare-ups while others may enter remission. Managing lupus during pregnancy involves careful monitoring for potential complications like pre-eclampsia and preterm birth.
Can you get lupus after pregnancy?
While it’s uncommon, some women may develop lupus or experience a lupus flare-up after pregnancy. This phenomenon, known as postpartum lupus, typically occurs within the first few months after giving birth. The exact cause is not fully understood, but hormonal changes and shifts in the immune system during pregnancy and childbirth may play a role. Symptoms of postpartum lupus can vary widely and may include joint pain, fatigue, rash, and fever.
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The Los Angeles Fetal & Maternal Care Center (hereafter referred to as the “Clinic”) supports initiatives that improve the quality of medical and health information available on the World Wide Web.
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Your personal information, including SMS consent and phone numbers, will not be sold, disclosed, or shared with any third party under any circumstances.
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As a result, we pledge the following:
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We collect phone numbers from our patients and obtain consent to send SMS notifications or updates related to our services. We do not share these phone numbers with any third parties or affiliates for marketing purposes. The phone numbers provided are strictly used to contact the website visitor so we may fulfill their request (such as scheduling a consultation, etc.), obtain consent for SMS communication, and deliver relevant updates or notifications.
We are committed to safeguarding our patients’ privacy and ensuring that their personal information, including phone numbers, is protected from unauthorized access or misuse.
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Where appropriate, this site’s information will be supported by clear references to source data and, where possible, specific HTML links to that data. The date when a clinical page was last modified will be displayed.
The source of the medically related content is written by the doctors and medical staff of the Clinic. Authorship is attributed to the content page, and all information is medically reviewed by the clinic’s education team.
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Any claims relating to the benefits/performance of a specific treatment, commercial product or service will be supported by appropriate, balanced evidence in the manner outlined above.
Please note that there are no guarantees that every medical treatment or surgery will satisfactorily cure or repair every condition for every person every single time.
Regarding any before and after pictures displayed on our website, the following are true:
The person in the before picture and the after picture are the same.
The pictures were not digitally modified or enhanced.
Each surgery produces unique results for each patient, and no one can guarantee the same result for every person visiting our website.
The Clinic has the explicit consent of its patients to take their pictures and publish them on your website.
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The designers of this Website will always seek to provide information in the clearest possible manner and provide contact addresses for visitors that seek further information or support. The Webmaster’s e-mail address is private@drsteverad.com.
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modify or copy the materials;
use the materials for any commercial use or any public presentation (business or non-business);
attempt to decompile or rebuild any product or material contained on the Clinic’s site;
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transfer the materials to someone else or even “mirror” the materials on another server.
This permit might consequently be terminated if you disregard any of these confinements and may be ended by the Clinic whenever deemed necessary. After permit termination or when your viewing permit is terminated, you must destroy any downloaded materials in your ownership, whether in electronic or printed form.
3. Disclaimer The materials on the Clinic’s site are given “as is.” The Clinic makes no guarantees, communicated or suggested, and thus renounces and nullifies every other warranty, including without impediment, inferred guarantees, or states of merchantability, fitness for a specific reason, or non-encroachment of licensed property or other infringement of rights. Further, the Clinic does not warrant or make any representations concerning the precision, likely results, or unwavering quality of the utilization of the materials on its Internet site or generally identifying with such materials or on any destinations connected to this website.
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5. Amendments and Errata The materials on the clinic’s site could incorporate typographical or photographic mistakes. The Clinic does not warrant that any materials on its site are exact, finished, or current. The Clinic may roll out improvements to the materials on its site whenever without notification. The Clinic does not, then again, make any dedication to update the materials.
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About Good Faith Estimates
Dear Patient,
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, examinations, office visits prescription drugs, and equipment (items or services reasonably expected to be furnished by this practice).
Make sure your health care provider gives you a Good Faith Estimate in writing at least one (1) business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit https://www.cms.gov/nosurprises. To speak to our billing department, please call (844) 473-6100.
Thank you.
Dr. Rad and your friends at the Los Angeles Fetal & Maternal Care Center
Open Payments Database Notice
For informational purposes only, a link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page is provided here. The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public.
The Open Payments database is a federal tool used to search payments made by drug and device companies to physicians and teaching hospitals. It can be found at https://openpaymentsdata.cms.gov.
Review Policy
The Los Angeles Fetal & Maternal Care Center is dedicated to transparently publishing customer feedback and reviews. This policy applies to reviews submitted by patients through first- and third-party review sites monitored on this platform. We reserve the right to remove posts, comments, or reviews that violate our content policies and/or are suspected to be fraudulent.
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If you need immediate help or require an urgent appointment, please call us at (323) 678-5544.
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