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Neonatal Lupus — SCE Rheumatology MCQ

Instant feedback + full explanation. One question, done properly.

HardSLE & Antiphospholipid SyndromeNeonatal LupusSCE Rheumatology

A woman with systemic lupus erythematosus is anti-Ro positive and had a previous pregnancy complicated by congenital heart block. She is well controlled on hydroxychloroquine and wishes to conceive. Which medication plan is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Continue hydroxychloroquine and arrange specialist fetal-medicine surveillance

Explanation lettering: B = shown as A · A = shown as B

D is correct. Hydroxychloroquine is compatible with pregnancy and is generally continued because withdrawal risks maternal flare; in anti-Ro-positive pregnancy, especially after a previously affected fetus, joint rheumatology-obstetric and fetal-medicine surveillance is required. A incorrectly labels a recommended pregnancy-compatible drug as teratogenic. B introduces a genuinely teratogenic antimetabolite. C stops treatment precisely while ongoing maternal disease control remains important and invents a trimester restriction. E overstates an unproven preventive guarantee and exposes mother and fetus to prolonged glucocorticoid harm. Medication continuation does not replace counselling: the previous congenital-heart-block pregnancy substantially increases recurrence risk, so surveillance and contingency planning remain essential.

Reference: BSR guideline on prescribing drugs in pregnancy and breastfeeding — immunomodulatory drugs and corticosteroids: https://academic.oup.com/rheumatology/article/62/4/e48/6783012