Lupus nephritis and pregnancy. The rheumatologist’s opinion

Abstract

In the presence of lupus nephritis, the pregnancy remains a challenging problem, requiring a multidisciplinary monitoring. Such pregnancies are considered as high risk similar to those with maternal and fetal potential complications. Thus, these pregnancies must be planned, after a multidisciplinary evaluation, performed by obstetrician, rheumatologist and nephrologist. Inactive disease for at least 6 months before conception, absence of hypertension, heavy proteinuria or important renal dysfunction are associated with good maternal-fetal outcomes. Lupus nephritis flare and preeclampsia may occur, associating a poor prognosis. Therapeutic regimens must be adapted, taking into account the teratogenic effects of the drugs.