Which combination is used to reduce disease flares and risk of preeclampsia in pregnant patients with SLE?

Which combination is used to reduce disease flares and risk of preeclampsia in pregnant patients with SLE?

• A. Hydroxychloroquine and low-dose aspirin
• B. Methotrexate and high-dose steroids
• C. Cyclophosphamide and NSAIDs
• D. Rituximab and heparin

Answer: (A)

The best approach for pregnant patients with SLE is to keep the lupus disease activity as low as possible while also reducing the risk of preeclampsia. Hydroxychloroquine is a cornerstone during pregnancy because it decreases lupus flares and is associated with better maternal and fetal outcomes, and it is considered safe. Adding low-dose aspirin helps lower the risk of preeclampsia in high‑risk pregnancies, including those with SLE, by supporting placental perfusion and reducing thrombotic complications. Together, this combo targets both controlling lupus activity and preventing preeclampsia. The other regimens either pose teratogenic or maternal risks during pregnancy (such as methotrexate or cyclophosphamide), are not established for preventing preeclampsia (NSAIDs), or have uncertain safety data in pregnancy (rituximab).

The best approach for pregnant patients with SLE is to keep the lupus disease activity as low as possible while also reducing the risk of preeclampsia. Hydroxychloroquine is a cornerstone during pregnancy because it decreases lupus flares and is associated with better maternal and fetal outcomes, and it is considered safe. Adding low-dose aspirin helps lower the risk of preeclampsia in high‑risk pregnancies, including those with SLE, by supporting placental perfusion and reducing thrombotic complications. Together, this combo targets both controlling lupus activity and preventing preeclampsia. The other regimens either pose teratogenic or maternal risks during pregnancy (such as methotrexate or cyclophosphamide), are not established for preventing preeclampsia (NSAIDs), or have uncertain safety data in pregnancy (rituximab).