Table 2.

Pre-conception counselling evaluation regarding disease status.

Evaluation for Preconception Counselling
Clinical evaluation: anamnesis (important to find out if patient needed to increase or to add Prednisone or immunosuppressive therapy in the preceding 6 months for active disease) and complete physical exam
Lab evaluation: complete blood count, proteinuria, urinalysis, renal and hepatic function, glucose level, coagulation tests, inflammatory markers
Immune marker associated with active disease: low complement (C) level (C3, C4, C1q) and increased anti-double-strand DNA (anti-dsDNA)
Assessment of organ involvement with specific investigation (ultrasound, pulmonary function, imaging if required) and activity scores (e.g., SLEDAI-2K, LLDAS)
Check for existence of damage that might contraindicate pregnancy: pulmonary hypertension, low pulmonary function, cardiac failure, severe kidney failure, stroke or major thrombosis

Anti-dsDNA—anti-double strand DNA; C-complement; LLDAS—Lupus Low Disease Activity State; SLEDAI-2K—Systemic Lupus Erythematosus Diseases Activity Index 2000.