Table 2.

Key points in managing the pregnant SLE patients

	Observant	Timing	Monitoring details
Maternal monitoring	Obstetrician	First visit Repeated monthly until 20 weeks Every 2 weeks until 24 weeks Every week until delivery	History taking, physical examination, urine analysis (if dipstick is positive for protein, measure protein–creatinine ratio)
	Rheumatologist	First visit Repeat every month until postpartum	History taking, physical examination, complement, anti ds-DNA antibody, SS-A and SS-B antibodies, cardiolipin antibodies, lupus anticoagulant History taking, physical examination, complement
	Both	First visit Repeat every month until postpartum	CBC, chemistry (including uric acid, liver enzymes, creatinine) Protein–creatinine ratio
Fetal monitoring	Obstetrician	Starting at 16 weeks Starting at 24 weeks Repeated every week until delivery	Echocardiogram BPP, fetal growth, umbilical artery Doppler velocimetry
	Neonatologist	When signs of fetal compromise detected	Consultation for appropriate timing/mode of delivery
	Cardiologist	When signs of CHB or heart failure detected	Consultation for therapy and appropriate timing/mode of delivery

Abbreviations: SLE, systemic lupus erythematosus; CBC, complete blood count; BPP, biophysical profile; CHB, congenital heart block; dsDNA, double stranded DNA.