QuestionI AM A SLE PATIENT SINCE SEPTEMBER 2008. I AM HAVING NOW PLAQUINIL 300 MG PER NIGHT BEFORE SLEEP. I ALSO APPLIED PLAQUINIL 400 MG IN THE MIDDLE OF WINTER ( WHILE TEMP @ 5 D.CEL.)I HAVE A 5 YEARS DAUGHTER.
CAN I ACCEPT A CHILD, I MEAN CAN I GO FOR ANOTHER CHILD?
MY HUSBAND IS NOT CAPABLE MUCH TO PAY MORE THEN $1,500 FOR THE HOSPITAL & SUNDRY MATERNITY EXPENSES. PLEASE SUGGEST.
AnswerDear Rahima,
The ability to become pregnant remains normal with lupus, but sometimes the problem is in staying pregnant. With lupus, your risk for early and late pregnancy loss is increased. The actual risk for miscarriage is between 15-40%. If your body is producing those antibodies which cause inflammation and damage body tissue and try to destroy the part of your body seen as foreign, your risk for miscarriage and poor pregnancy outcome are increased.
Many doctors recommend becoming pregnant during a remission that has lasted at least five to seven months. It is unknown whether pregnancy increases your risk of flare-up of symptoms. Women with kidney involvement known as lupus nephritis have a small risk for significant permanent damage to their kidneys. If you do have active kidney involvement with your lupus and your kidneys are unable to function properly, your chances of developing preeclampsia are increased.
Your pregnancy would be considered high risk because of the many problems associated with lupus and pregnancy. Often the placenta does not function as well as it should, and babies can be very small. The baby may also be born with rashes on the face, scalp, and upper chest but these will normally disappear during the first year. Premature delivery and the possibility of the baby dying before birth are other complications.
The baby would also have a very small risk for developing a serious complication with the heart. Congenital heart block causes the baby's heart rate to beat around 60 times a minute instead of the normal 110 to 160. A formal cardiac ultrasound known as a fetal echocardiogram should be done after diagnosis of congenital heart block to look for other cardiac defects or malformations. Your doctor would work closely with a specialist in monitoring your baby before birth. These infants should be watched closely by ultrasound every 1-2 weeks and usually have no problems.
Occasionally, the baby develops swelling known as hydrops, or anasarca. This is a sign that the baby is having a problem known as congestive heart failure and must be watched closely in the hospital and often delivered prematurely. If your body is producing specific antibodies, known as SSA and SSB antibodies, your risk of having a baby with heart problems is greater.
Obviously, because a pregnancy would be high risk and would require much more monitoring of both you and the baby during the pregnancy, the medical costs would be quite a bit higher than a normal pregnancy and delivery. It sounds like that would have to be a serious consideration for you and your family.
I hope this information has helped you and answered your question. I wish you well.
Brenda
