Precautions for pregnant women with lupus in labor and delivery: 1, the first 2 years of the onset of the disease can not get pregnant and use contraceptives (especially unstable, antiphospholipid syndrome or nephrotic syndrome, hypercoagulable tendency or history of thrombosis), can not get pregnant during the non-stable period or those who have not been stabilized for a long period of time, especially those who have lupus nephritis, it is best to avoid getting pregnant. 2. For those who plan to get pregnant, it is better not to use immunosuppressants such as cyclophosphamide and mycophenolate mofetil, if necessary, azathioprine <2mg/(kg.d), it is better to measure the functional mercaptopurine methyltransferase (to prevent accumulation of drugs and myelosuppression), and it is possible to combine with cyclophosphamide A for severe lupus nephritis during pregnancy. Timing of pregnancy: no vital organ involvement (Cr<2mg/dl, urine protein<0.5g/d), the disease has been under control for more than 1-3 years (at least half a year), the amount of hormone is small (e.g., prednisone<15mg/d), and immunosuppressant drugs have not been used, because prednisone ≥20mg/d can increase the risk of eclampsia and gestational diabetes mellitus. 4, Pre-pregnancy tests: ANA, anti-ds-DNA, anti-SSA and SSB antibodies, lupus anticoagulant, C3, C4, CH50, blood electrolytes, liver function, blood and urine routine, creatinine clearance, 24h total protein and calcium, and if there is a decrease in platelets, check the antiplatelet antibodies and antiphospholipid antibodies. 5.Lupus patients are prone to miscarriage in the first 3 months of pregnancy, so they should insist on taking medication and avoid trauma and injury; the condition is likely to worsen in the second 3 months of pregnancy and after delivery (about 50%), so the condition should be closely monitored. 6.Frequency of follow-up for pregnant women with lupus: 1 visit every 4~6 weeks in the first 20 weeks of pregnancy, 1 visit every 2 weeks from 20 to 28 weeks of pregnancy, and 1 visit every week after 28 weeks of pregnancy, with follow-up on changes in condition, physical examination, blood routine, blood biochemistry, urine routine, anti-ds-DNA antibody, complement C3 and C4, CH50, uric acid and anticardiolipin antibody, etc. Lowering of complement, increase of anti-ds-DNA antibody and CRP suggests that the risk of preterm labor is higher, and the blood uric acid is also higher than the blood uric acid. Increased blood uric acid level can help to identify preeclampsia and lupus nephritis. 7.In case of hyperemesis gravidarum, blood pressure should be controlled below 140/90mmHg, and ACEI and ARB should not be used in order to prevent fetal renal dysplasia. Thiazide diuretics can be used, but not combined with diuretics to avoid reducing fetal blood flow. Use methyldopa, hydralazine and labetalol. 8, close monitoring of blood pressure and urine protein, once abnormal, need to identify whether lupus nephritis or pre-eclampsia, suggesting that lupus nephritis indications include: systemic lupus activity; reactive urinary sediment; a significant decrease in complement; blood uric acid levels increased. For anti-SSA and SSB positive or previous congestive heart failure, pay attention to congestive heart failure between 16-24 weeks of pregnancy. 9. Use low-dose aspirin in combination with low-molecular heparin to reduce the risk of miscarriage and thrombosis in patients with combined antiphospholipid syndrome, whereas aspirin alone may be used in patients with antiphospholipid antibodies only. 10.Fetal monitoring = 1 * GB3 (1) early pregnancy: from the 10th week, each visit to monitor the fetal heartbeat; = 2 * GB3 (2) mid-pregnancy: every 2 weeks to visit the clinic, monitoring fetal heartbeat; the 18th-20th week of the application of ultrasound to check for congenital defects; through the determination of the uterine fundus height to assess the developmental state of the fetus, the application of ultrasonography, if necessary; = 3 * GB3 (3) late pregnancy: every 3-4 weeks of ultrasound examination; = 3 * GB3 (3) late pregnancy: every 3-4 weeks of ultrasound examination. 3-4 weeks for ultrasonography; weekly uterine fundal height to assess the developmental status of the fetus; 28th-30th week for biophysical testing (e.g., amniotic fluid volume, fetal movement, respiration, and fetal heart sounds) by application of a multispectral; if still unsure, closer follow-up should be performed, and oxytocin contraction test or induction of labor should be performed if necessary. Indications for termination of pregnancy: =1*GB3 (1) cardiac involvement, such as endocarditis, myocarditis and cardiac insufficiency; =2*GB3 (2) progressive glomerulonephritis or renal failure; =3*GB3 (3) nephrotic syndrome; =4*GB3 (4) although there is no obvious symptom, but the immune monitoring indicators are obviously elevated. 12, delivery: 37 weeks of pregnancy, if the condition is stable or mild activity and no contraindication, vaginal delivery; when high-dose hormone therapy is still difficult to control the condition or the need to add immunosuppressive drugs is appropriate to choose cesarean section. 13, anesthesia: according to the specific analysis of the specific situation, no abnormalities, epidural anesthesia is the main; and platelets less than 20 × 109 / L to general anesthesia (requiring fetal cesarean section within 3 minutes) is the main; 14, long-term use of hormones, the need to temporarily increase the amount of hormones in the operation; 15, the need for postoperative haemostasis, to promote contractions and anti-inflammatory. 16, whether breastfeeding, mainly depends on whether the condition is serious and taking drugs, if the condition is stable, can withstand busy, and taking drugs with little toxicity, only small doses of hormones and hydroxychloroquine, etc., should be able to breastfeeding.