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Anti-Ro pregnancy — SCE Rheumatology MCQ

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HardPregnancy in rheumatic disease and rare conditionsAnti-Ro pregnancySCE Rheumatology

A pregnant patient with stable anti-Ro-positive systemic lupus erythematosus takes hydroxychloroquine and previously had an infant with congenital heart block. What should happen to hydroxychloroquine?

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

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Correct answer: B — Continue hydroxychloroquine throughout pregnancy at the established dose

Hydroxychloroquine is compatible with pregnancy and should usually be continued to reduce maternal flare risk; evidence also supports reduced recurrence of anti-Ro-associated congenital heart block. Fetal surveillance is arranged in addition and is not a reason to withdraw maternal therapy.

Reference: BSR guideline on immunomodulatory antirheumatic drugs in pregnancy and breastfeeding (Published November 2022): https://academic.oup.com/rheumatology/article/62/4/e48/6783012; BNF: hydroxychloroquine sulfate (Current BNF monograph, accessed 30 July 2026): https://bnf.nice.org.uk/drugs/hydroxychloroquine-sulfate/