Autoimmune and Rheumatic Conditions in Pregnancy
Learn more about pregnancy care for patients with autoimmune and rheumatic conditions.
Overview
If you have an autoimmune or rheumatic condition, it is important to have specialized care during pregnancy.
Our maternal-fetal medicine (MFM) specialists are high-risk obstetricians who provide comprehensive care for patients with rheumatic and other health conditions including the following:
- Systemic lupus erythematosus (SLE)
- Rheumatoid arthritis
- Sjogren's syndrome
- Psoriatic arthritis
- Ankylosing spondylitis
- And others
Certain conditions like rheumatoid arthritis may improve during pregnancy while other conditions like lupus may be more likely to flare up.
If you are not currently pregnant, we encourage you to speak with your family physician or rheumatologist before planning a pregnancy. Being in remission before your pregnancy will greatly improve your chances of a successful outcome.
Your pregnancy care
It is important to us that you actively participate in decision-making about your care. Our MFM specialists will help you understand your treatment choices so that you can make the best possible decisions for both you and your baby.
Our MFM specialists work closely with specialists who have expertise in pregnancy. You will have prenatal appointments with your MFM specialist at the Medical Disorders of Pregnancy Clinic. You may also have appointments with other specialists such as a rheumatologist.
We will also refer you to our Pediatrics team as needed to discuss any testing or follow-up for your baby.
Treatment
Care plans will focus on managing your condition and monitoring the health of both you and your baby.
Your MFM specialist will work with you to decide on a care plan that is specific to your needs.
Your care plan may include any of the following:
- Preconception counseling
- Monitoring for flares through blood work and symptom reporting
- Low-dose aspirin to help with placental health
- Adding medication to manage your condition
- Changing to medication that is both safe and effective during pregnancy
- Fetal echocardiograms to monitor the risk of fetal congenital heart block (if anti-Ro or anti-La antibodies are present)
Labour and delivery
Our recommendations for your labour and delivery care may include any of the following:
- Meeting with our Obstetric Anesthesia team
- Scheduling an induction of labour or Caesarean section if needed
- Monitoring your health throughout labour
- Monitoring the health of your baby
It is important to continue to see your specialist after delivery. Postpartum flares are common and might require a change to your medication.