Sunday, June 12, 2022

Do you want to get pregnant but have lupus? Prepare ahead of time

Prepare ahead of time

During childbearing years, lupus (systemic lupus erythematosus, or SLE) disproportionately affects women, as do many autoimmune illnesses. Lupus is one of more than 80 auto-immune diseases that affect an estimated 23 million Americans and close to 350 million people globally. If you have lupus or another autoimmune disease and you wish to have children, it is prudent to plan ahead.
In the past, it was advised that individuals with lupus or other autoimmune illnesses avoid pregnancy. The belief was that it was simply too dangerous for mother and child. no longer accurate; in the majority of cases, a successful pregnancy can be achieved by adhering to the current expert guidance. These recommendations outline best practices for a variety of family planning difficulties. Below, we address some frequently asked questions regarding conception, pregnancy, childbirth, and breastfeeding.

How can my fertility be affected by lupus or its treatment?
Approximately 90% of lupus patients are naturally female, and the disease often manifests between the ages of 15 and 35. Thus, family planning is an essential aspect of lupus treatment.
Historically, physicians believed that active lupus impaired fertility to such an extent that conception was unlikely. Despite the fact that this myth has been refuted for decades, women with lupus may take longer than expected to become pregnant. In order to conduct a thorough evaluation of your situation, your prenatal practitioner or rheumatologist may recommend that you consult a maternal-fetal medicine expert with experience treating pregnant women with reproductive concerns. In vitro fertilization may be a viable option for lupus patients who struggle with infertility.

Because certain medications, such as cyclophosphamide, may impair fertility, your physician may advise you to alter your dosage. Egg freezing is an alternative method. It could be done before starting medicine that lowers fertility or to save younger, healthier eggs in case pregnancy has to be put off for a while.
Will I need to change my treatment prior to becoming pregnant?
This depends on the medications you take and how well your sickness is managed. Ideal contraception would last at least three to six months prior to conception. Both you and the pregnancy are at risk if you become pregnant unintentionally.

If your lupus is not well controlled or if it affects important organs like the heart, lungs, or kidneys, you may be told to stop trying to get pregnant, at least for a while, or to switch medications to better control your disease.

Some lupus medications are harmful to a developing child and should be avoided during pregnancy. Methotrexate, mycophenolate, and cyclophosphamide are examples. However, the health and well-being of the mother must also be considered, as changing the mother's medications may put her health in danger. You can make changes to your therapy to make it safer if you plan ahead and get your doctors to work together.

What more should I do before attempting to fall pregnant?
Prenatal vitamins and/or folic acid supplements are highly recommended. Consult your physician for precise suggestions. If you smoke, you should cease immediately. Numerous health concerns are associated with nicotine products, including an increased risk of cancer, heart attack, stroke, and lung disease. In addition, the combination of lupus, pregnancy, and smoking might significantly raise the risk of irregular blood coagulation. If quitting has been tough for you, seek assistance from your healthcare team. Your physician may suggest medications or nicotine replacement therapy to assist you in quitting.

How might pregnancy impact my condition?
Many individuals with lupus do not observe a significant change in their condition during pregnancy. However, research indicates that lupus flare-ups are more common during pregnancy than afterwards. Among the most prevalent complication of lupus, pregnancies are high blood pressure, premature delivery, stillbirth, and poor fetal growth.
Your doctor will likely advise you to continue lupus therapies that are safe for the growing fetus, such as hydroxychloroquine, and to take aspirin to prevent problems. During pregnancy, you need to be closely watched so that doctors can find and treat lupus flare-ups or any of these other problems.

How will my prenatal visits be affected by my lupus? 
Due to the increased risk of pregnancy complications in lupus patients, a doctor specializing in maternal-fetal medicine is frequently included on your medical team. Additionally, the timetable of standard tests to detect pregnancy may be altered. For instance, women with lupus may have an increased risk of developing diabetes during pregnancy, presumably due to steroid treatment. So, a diabetes test may need to be done before the usual 24 to 28 weeks of pregnancy.

If you have certain antibodies in your blood (particularly anti-Ro and anti-La antibodies), your doctors may urge more regular fetal monitoring, paying special attention to the heart's development. Even if everything is proceeding properly, it is crucial not to miss prenatal appointments.
During pregnancy, do those with lupus have additional pain?
Even without lupus, pregnancy can be unpleasant! Numerous lupus-affected women also suffer from arthritis, fibromyalgia, or other pain conditions. Daily activity is beneficial. Before, during, and after pregnancy, yoga, walking, and swimming are excellent kinds of exercise.

What about pregnancy? 
Fortunately, the majority of women with lupus deliver normally. If you were taking blood thinners during pregnancy to avoid irregular clotting, your health care team may be more careful about your risk of bleeding after birth and will be prepared with medications and blood transfusions. For women with lupus, epidural anesthesia, cesarean sections, and other procedures are often available as needed.

What more is useful to understand?
Some women develop lupus flare-ups in the weeks following childbirth. Your health care team will continuously watch you for this potential.

If you intend to breastfeed, discuss your medications with your care team. Several medications, including hydroxychloroquine, are safe for nursing mothers to use.
If a woman has lupus, she can usually get pregnant safely and effectively. When it comes to family planning for persons with any type of autoimmune disease, it is crucial to find trustworthy information sources, plan ahead, interact regularly with your health care provider, and — most importantly — ask many questions.

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