The most important issue is the level of lupus activity you are experiencing. Preeclampsia at 14 weeks is very unusual and, when it happens, is usually driven by another disease process such as lupus. It is very difficult to tell a lupus flare from preeclampsia.
Some rheumatologists consider a very aggressive approach to lupus prior to pregnancy. Patients can be treated with drugs used in chemotherapy. Sometimes the results are very dramatic - not always. I cannot tell if such an approach could help you. (You would need to discuss it with your rheumatologist). There can be significant complications which include injury to your ovaries that would reduce your fertility-- a hard choice.
Is you blood pressure normal? Is your renal function normal? Do you have protein in your urine? If there is protein in your urine, treatment with a class of antihypertensive agents (ACE-inhibitors) can reduce the proteinuria. These drugs are not used in pregnancy but can be stopped in the first months of pregnancy without risk.
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I have had Lupus since age 9, and after careful consideration and consultation with many specialists including my rheumatologist and Perinatologists, we decided to try and conceive. Almost two years ago at age 27 I became pregnant with my first child. Fourteen weeks into the pregnancy, I developed Preeclampsia. During the nightmare that is Preeclampsia, we had to terminate the pregnancy to save me from getting any sicker. This is my question: We are now considering another pregnancy. We have tested for possible culprits as to why I got sick so early, including antiphospholipid syndrome and others. My antiphospholipid tests are sometimes positive and sometimes negitive. So, as a precaution, I am now on 4 mg of folic acid a day (elevated homocystine enzyme), low dose aspirin (81 mg/day), Prednisone (15 mg/day), Placquinil (400 mg/day), and have been told that if I do get pregnant, Heparin injections immediately. Are there any other precautions I can take to help minimize my chances of going through this again? Diet modifications that might help? Thank you!
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