🦋 Pregnancy-in-Lupus Risk Management Simulator

Pre-Conception Disease Activity Assessment

Quiescent disease before pregnancy predicts far better maternal and fetal outcomes.

• 6 mo: Ideal quiescence window (stable disease before conception)
• ~60%: Flare risk if active (placeholder estimate)
• ~10%: Flare risk if quiescent (placeholder estimate)
• C3/C4, dsDNA: Key labs (placeholder monitoring panel)

Why timing conception matters

Placeholder: counseling should target disease quiescence before pregnancy is attempted.

Placeholder callout: pre-conception planning is the single strongest predictor of outcome.

Antiphospholipid Syndrome Risk Screening

Antiphospholipid antibodies raise risk of clotting and pregnancy loss.

• tested: Lupus anticoagulant (placeholder screening marker)
• tested: Anticardiolipin IgG/IgM (placeholder screening marker)
• tested: Anti-β2GPI (placeholder screening marker)
• highest: Triple-positive risk (placeholder risk tier)

Antibody panel and thrombosis risk

Placeholder: triple antibody positivity carries the greatest obstetric risk.

Placeholder callout: aspirin plus heparin is standard for obstetric APS.

Flare Risk During Pregnancy

Pregnancy itself can trigger lupus flares, especially with active baseline disease.

• 2nd/3rd: Flares by trimester (placeholder peak timing)
• continued: Hydroxychloroquine (placeholder safe therapy)
• overlap: Flare vs preeclampsia (placeholder distinction challenge)
• monthly: Monitoring interval (placeholder visit cadence)

Distinguishing flare from preeclampsia

Placeholder: complement and dsDNA trends help separate flare from preeclampsia.

Placeholder callout: continue hydroxychloroquine throughout pregnancy.

Anti-Ro/SSA Antibody Placental Transfer

Maternal Ro/SSA antibodies actively cross the placenta in the second trimester.

• ~16-18 wk: Transfer onset (placeholder gestational window)
• IgG: Antibody class (placeholder active transport)
• ~30%: Ro/SSA prevalence (placeholder SLE cohort estimate)
• Anti-La/SSB: Overlap antibody (placeholder co-occurring marker)

Mechanism of transplacental transfer

Placeholder: FcRn-mediated transport carries maternal IgG into fetal circulation.

Placeholder callout: transfer timing defines the fetal surveillance window.

Neonatal Lupus and Heart Block Monitoring

Serial fetal echocardiograms detect conduction injury before irreversible heart block.

• ~2%: Heart block risk (placeholder first pregnancy estimate)
• ~15-20%: Recurrence risk (placeholder subsequent pregnancy)
• 16-26 wk: Echo screening window (placeholder surveillance period)
• both monitored: Skin/cardiac lupus (placeholder neonatal manifestations)

Surveillance and intervention window

Placeholder: weekly echo during the risk window can catch early first-degree block.

Placeholder callout: complete heart block is usually irreversible once established.