Table 4.

Monitoring guideline for pregnancies complicated by lupus

Month	Labs	Maternal monitoring	Fetal monitoring
First trimester	CBC with differential and platelets, BUN, creatinine, liver function tests, glucose, albumin, urinalysis, urine protein/creatinine ratio, C3, C4, CH50, anti-ds-DNA antibody, anti-cardiolipin antibody, RPR, lupus anticoagulant, anti-Ro,/SSA antibody, anti-La/SSB antibody, protein S activity, extended thrombophilia profile	Chest x-ray (optional) Pulmonary function testing (optional) Echocardiogram (optional) Lupus Disease Activity Index Assessment Hypertension and renal monitoring
16 weeks			First fetal ECHO
Monthly visits	CBC with differential and platelets, BUN, creatinine, liver function tests, glucose, albumin, urinalysis, urine protein/creatinine ratio, C3, C4, CH50, anti-ds-DNA antibody, anti-cardiolipin antibody, protein S activity, select coagulation tests	Lupus disease activity assessment Hypertension and renal monitoring	Fetal ECHO every1-2 weeks after 16 weeks

BUN, blood urea nitrogen; CBC, complete blood count; ds-DNA, double stranded deoxyribonucleic acid; RPR, rapid plasma regain