"Wolf Warrior" Handbook | A list of things to pay attention to for "wolf" mothers, listed here for you

Systemic lupus erythematosus has a characteristic that the incidence and prevalence of female patients are significantly higher than those of male patients, about 6:1, and the main affected population is women of childbearing age. SLE itself does not affect the patient's fertility, and most patients can successfully become pregnant, but pregnancy in SLE patients is a high-risk pregnancy, and the risk of serious complications for pregnant women and fetuses is increased, such as pregnancy loss, premature birth, fetal growth restriction, eclampsia, preeclampsia and HELLP syndrome (a serious complication of hypertensive disorders complicating pregnancy).

When SLE patients become pregnant, the goal is to maximize the success rate of pregnancy, minimize pregnancy complications, and improve the survival rate of mother and baby. So, what are the precautions for SLE patients to be pregnant?

The following is a list made by Yaohuluwa for you:

Pregnancy

Regular inspection

Specialist follow-up. Once the pregnancy is confirmed by the obstetrics department, the patient needs to be followed up by a rheumatologist immediately. Before the 28th week of pregnancy, the patient needs to be checked by the rheumatologist and obstetrics department every 4 weeks; starting from the 28th week, the patient needs to be checked every 2 weeks. If the disease is likely to recur, the follow-up interval needs to be shortened.

Take medication as directed by your doctor

1. The impact of pregnancy on SLE, the proportion of remission and exacerbation is approximately similar. Hydroxychloroquine, hormones, azathioprine, cyclosporine A and tacrolimus can be used to prevent or control SLE relapse during pregnancy. For patients with active disease during pregnancy, hormones, hydroxychloroquine and immunosuppressants can be considered in combination.

2. The use of glucocorticoids within 3 months of pregnancy may increase the risk of cleft lip and palate in the fetus. Therefore, if it is necessary to use it due to medical conditions, it is not recommended to use medium or high doses within 3 months of pregnancy. During medication, you should try to maintain a low-sodium, high-potassium, high-protein diet, and supplement calcium and vitamin D.

3. Drugs that pose risks to the fetus should not be used, such as mycophenolate mofetil, cyclophosphamide, leflunomide, and methotrexate.

4. Avoid the use of drugs that induce SLE symptoms, such as sulfonamides, penicillin, streptomycin, propranolol, methyldopa, reserpine, vaccines, and oral contraceptives.

Life

1. Avoid contact with common hazardous substances. For example, some cosmetics contain ingredients that may induce SLE, such as hair dyes, eyebrow tattoo agents, etc.

2. Pay attention to sun protection.

3. Do moderate exercise.

4. Quit smoking.

5. Pay attention to psychological support.

Lactation

If the pregnant mother has safely passed the pregnancy, she should also pay attention to preventing and controlling the recurrence of SLE during the breastfeeding period.

1. Newborns should be followed up closely, starting at 2 weeks after birth, every month after one month, until 6 months after birth, and then every 3 months thereafter, at least until 1 year old.

2. New mothers still need to continue taking medication and follow up with the rheumatology and immunology department to adjust medication according to changes in their condition.

3. Breast milk is the most natural and safe food for infants. It is rich in nutrients, immune active substances and water, and can meet all the nutritional needs of infants aged 0 to 6 months. It cannot be replaced by any formula milk, cow's milk or goat's milk. SLE mothers should not give up this nutritious meal for their babies easily. Patients who take oral prednisone, hydroxychloroquine and non-steroidal anti-inflammatory drugs during lactation can breastfeed. If the dose of prednisone exceeds 20 mg/d or an equivalent dose, the breast milk within 4 hours after taking the medicine should be discarded, and breastfeeding should be resumed 4 hours after taking the medicine.

Scientific preparation for pregnancy, scientific feeding,

Take medicine regularly and have checkups regularly.

You can also become a happy "wolf" mother.

Author: Zhang Na, Chief Pharmacist of Shijiazhuang Fourth Hospital

Review expert: Wang Baoxin, deputy chief physician of the Department of Pharmacy, Peking University First Hospital