All are true about SLE in pregnancy except?
Correct Answer: Increased anti Ro and La implies low risk for congenital hea block
Description: Increased anti Ro and La implies high risk of congenital hea block. Anti Ro antibody can be transmitted transplacentally and can lead to complete hea block leading to neonatal lupus. Steroids can be given in pregnancy as they fall in category A with no evidence of teratogenicity. But a placental enzyme 11 dehydrogenase deactivates glucocoicoids. Presence of anti-cardiolipin antibody and anti beta 2 glycoprotein antibody can lead to uterine aery or venous thrombosis leading to recurrent aboions. Most women can tolerate pregnancy without flare but it can worsen in some requiring aggressive treatment. All autoimmune diseases can worsen in pregnancy except rheumatoid ahritis.
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