Systemic lupus erythematosus (SLE) is a chronic autoimmune disease where the immune system mistakenly attacks multiple organs, including the skin, kidneys, heart, and lungs. The disease typically progresses in stages and can easily relapse without continuous treatment.

Associate Professor Doctor Hoang Thi Lam, Head of the Clinical Immunology Department at Tam Anh General Hospital in Ho Chi Minh City, explained that women with lupus often experience menstrual irregularities. Combined with the side effects of certain medications, this reduces the likelihood of natural conception and can cause birth defects. "Loan was in a stable phase of treatment, and her pregnancy symptoms were easily mistaken for lupus symptoms, leading to a late pregnancy discovery," said Lam.

Pregnancy with lupus presents many risks, including birth defects, slow fetal growth, and miscarriage. The mother faces a higher risk of preeclampsia, premature birth, and severe lupus flare-ups. For Loan, the challenges were even greater due to multiple previous treatments in the intensive care unit (ICU), including continuous dialysis for acute renal failure, pneumonia, and sepsis. After stabilizing, she was discharged with maintenance medication and scheduled for follow-up appointments every three months. However, she once stopped taking her medication for a week, causing a severe lupus relapse.

"The news of the pregnancy was a complete surprise and indescribable joy for my husband and me after years of hoping for a child," Loan said, expressing her determination to continue the pregnancy despite the risks.

Loan's husband accompanies her to every follow-up appointment. Photo: Tam Anh General Hospital

Loan's husband accompanies her to every follow-up appointment. Photo: Tam Anh General Hospital

Lam consulted with an obstetrician and decided to discontinue or replace medications contraindicated during pregnancy while maintaining or switching to safer options for both mother and baby. Fortunately, Loan conceived during a stable phase of her illness, avoiding an acute lupus flare-up. The fetal development indicators were all within normal limits, making the chances of a successful pregnancy higher.

Throughout the pregnancy, the obstetrician and the clinical immunologist monitored Loan and the fetus, conducting monthly check-ups to manage the lupus and assess the baby's development. During the 5th month, tests revealed severe anemia due to hormonal changes and the increased demands on Loan's body to nourish the fetus while combating the inflammatory effects of lupus. Doctors administered blood transfusions promptly to prevent further complications.

Loan maintained a healthy diet, eating several meals daily, and adhered to her frequent check-up schedule. Her health stabilized, inflammation markers decreased, and the anemia significantly improved. The fetus developed steadily, with no abnormalities detected through ultrasounds. She is expected to give birth in November.

Lam noted that women with SLE can conceive naturally, but it is more difficult and carries higher risks, especially if the disease is not well-controlled. Patients should undergo treatment for at least 6-12 months before attempting pregnancy. Expectant mothers should not discontinue medication without consulting their doctor and should adhere to their appointments with both an obstetrician and a clinical immunologist for close monitoring. If any unusual symptoms occur, such as high fever, swelling, shortness of breath, anemia, or bleeding, immediate medical attention is crucial.

Minh Huong

*Name has been changed.