Lupus erythematosus is an immune rheumatic disease that women of childbearing age are prone to. In the past, lupus patients were considered to be at high risk of childbirth and prone to death, and childbirth was not advocated, causing many women to lose their right to motherhood because they could not have children, and causing many families to break up because the female partner did not want to have children. In recent years, with the improvement of diagnosis and treatment and the progress of monitoring methods, lupus patients can have children like normal people. The authors have more than 20 cases of successful motherhood in women with lupus over the years, and now we would like to give a brief introduction on common problems and countermeasures in childbirth of lupus patients. 1. Lupus activity and pregnancy affect each other. The fertility of patients with lupus erythematosus is normal, but pregnancy is risky. Lupus activity makes the incidence of preterm labor, stillbirth, miscarriage, intrauterine growth retardation, eclampsia and pre-eclampsia high, which is a high-risk pregnancy, and pregnancy can also trigger lupus activity and aggravate the disease. Once pregnancy is determined, it should be planned and requires the cooperation of rheumatology, obstetrics and family members to make a detailed and thorough plan. 2. Timing of pregnancy. If a patient with lupus wants to have a baby, pregnancy is possible after the doctor’s assessment: (1) The disease has been stable for at least 6 months (preferably 1 year). (2) 24-hour urine protein quantification <0.5g. (3) No significant organ damage. (4) Hormone equivalent to prednisone amount less than 15 mg per day. (5) Stop immunosuppressants (cyclophosphamide, methotrexate, raltegravir, leflunomide, mescaline) for more than six months. (6) No medications contraindicated during pregnancy. Failure to meet the above criteria, contraception should be used. 3.Follow-up after pregnancy. Once a lupus patient is pregnant, she should visit the rheumatology and obstetrics departments regularly and on time, usually once every 4 weeks within 28 weeks, and once every 2 weeks from 28 weeks to delivery, and the number of follow-up visits can be increased under special circumstances. The follow-up visits to the rheumatology department include the manifestation of lupus changes, blood and urine routine, liver and kidney function, 24-hour urine protein quantification, immunoglobulin and complement, blood glucose, blood lipids, electrolytes, anti-DSDNA antibody, neo-phospholipid antibody and anti-B2-glycoprotein 1 antibody; the follow-up visits to the obstetrics department include routine obstetrical examination, blood pressure, fetal ultrasound monitoring, fetal heart monitoring and fetal cardiac ultrasound, etc. 4. Management of lupus activity during pregnancy. Pregnancy can induce lupus activity, and once the disease is active, it should be actively managed to ensure maternal safety. Pregnancy should be terminated in the first 3 months for severe disease activity; increase the dose of prednisone to 20mg/day for 4 weeks for mild activity, then gradually reduce the dose to 15mg/day or less for maintenance, and add hydroxychloroquine 0.4/day if hydroxychloroquine was not used before pregnancy; high-dose prednisone or methylprednisolone shock for moderate or severe disease activity, and reduce the dose to prednisone 15mg/day or less as soon as possible, and add immunosuppressants if the disease requires, especially In severe renal disease requiring immunosuppressive therapy, azathioprine, cyclosporine or tacrolimus may be used. In case of combined antiphospholipid antibody syndrome, aspirin or heparin should be chosen according to the condition. 5. Drugs for the treatment of lupus allowed during pregnancy. Patients with lupus cannot stop the medication. In pregnancy, it is better to use hormones such as prednisone, methylprednisolone and other fluorine-free formulations, and use the minimum dose that can control the disease, such as prednisone not exceeding 15mg/day, and dexamethasone for neonatal lupus or to promote the maturation of fetal lung development. If you have taken the above drugs, you should stop taking them for six months before pregnancy. Leflunomide should be used to remove the drugs from your body before stopping for six months. Hydroxychloroquine is safe and available. 6, the choice of birth mode. Stable condition throughout the pregnancy can be delivered naturally, while those with unstable condition or obstetric complications during pregnancy can be delivered by cesarean section. 7. Termination of pregnancy. Pregnancy should be terminated when maternal safety is endangered by obvious lupus activity in the first 3 months of pregnancy. Pregnancy should be terminated if monitoring of low placental function during pregnancy endangers the fetus and does not improve with obstetric and rheumatologic treatment; or if the following complications occur, such as severe gestational hypertensive syndrome, psychiatric abnormalities, cerebrovascular accident, heart failure, diffuse interstitial lung lesion with respiratory failure, 24-hour urine protein quantification >3 grams with severe swelling. Termination of pregnancy is also recommended when the fetus is mature at 38 weeks of gestation. 8. Hormone dosage at delivery. If you take prednisone 5mg/day or less, you do not need to increase the amount of hormone during delivery. For patients who take prednisone 5mg/day or more, hormone supplementation should be given during surgery. For normal delivery, abortion or midterm induction of labor, prednisone 5mg or equivalent dose of hormone should be added on the day of surgery, or methylprednisolone 5mg or hydrocortisone 25mg should be injected intravenously half an hour before surgery, and the oral dose should be resumed on the next day of surgery; cesarean section should be given intravenously during surgery on the basis of the original oral dose. The following day after surgery, hydrocortisone 20mg should be given once every 8 hours, and the preoperative dosage should be resumed on the third day after surgery. 9. Breastfeeding and lupus medication. Those who take prednisone or methylprednisolone or hydroxychloroquine can breastfeed. If prednisone exceeds 20mg/day or when you want to be a dose of hormone, you should discard the breast milk within 4 hours after taking the medicine and breastfeed after 4 hours of taking the medicine. Breastfeeding is also allowed when taking aspirin, warfarin or using heparin. Those taking methotrexate, cyclophosphamide, leflunomide, mescaline, cyclosporine, tacrolimus cannot breastfeed.