Table 3 Pre-pregnancy counselling checklist for day-to-day standard practice

- Key question: Are you planning for a family or getting pregnant in the near future?

- Meeting with the patient and her husband (preferable)

- For women who are not planning for a family, discuss different birth control methods

- Ensure both SLE disease activity as well as LN are controlled for at least 6 months (advise to delay the pregnancy and discuss methods of birth control if the disease activity is moderate to severe)

- Review the patient’s current medication and identify whether they are safe during pregnancy and breastfeeding

- Blood tests for: anti-Ro/SSA, anti-La/SSB antibodies, antiphospholipid antibodies as well as lupus anticoagulant

- Assess for the presence of comorbidities (e.g. diabetes, hypertension, renal disease, cardiovascular events) and whether they are controlled

- Multidisciplinary approach with a team including a rheumatologist, Obstetrician, nephrologist, as well as neonatologist/paediatric cardiologist