A variety of physical abnormalities may occur during pregnancy in SLE patients, but it can be difficult to distinguish whether these abnormalities are due to lupus activity or to the pregnancy itself. For example, patients usually feel fatigued and weak when lupus is active, whereas healthy women may also feel quite fatigued in early pregnancy; the appearance of a rash on the face of a pregnant woman may be related to pregnancy and not necessarily caused by SLE; most lupus patients are anemic when active, whereas red blood cell counts tend to decrease during normal pregnancy due to increased circulating volume, which is also known as “physiologic anemia”; protein can sometimes be detected in the urine of women with normal pregnancies, probably due to increased blood flow through the kidneys, which does not mean that lupus has involved the kidneys. However, the correct and timely recognition of lupus activity is important for both the pregnant woman and the fetus, and doctors usually use clinical observation and various blood tests to follow and monitor the condition of SLE patients. For example, a decrease in complement levels would have been valuable in determining lupus activity, but because complement levels may be elevated in pregnant women, the results of complement tests may be affected and may not reflect the activity of the disease. Similarly, the blood sedimentation of a pregnant woman may be elevated due to “physiologic anemia,” so an elevated blood sedimentation may not necessarily indicate disease activity. However, the presence of conditions such as profuse proteinuria, decreased renal filtration, neuropsychiatric symptoms, severe arthritis, heart failure or pulmonary edema, severe nasal or oral ulcers, etc. are likely to indicate lupus activity. If the condition is very severe, such as a patient with more severe central nervous system pathology or significant renal decompensation, and if these conditions occur before 12 weeks of gestation, termination of pregnancy should be considered, followed by shock therapy with cyclophosphamide in some patients. If these conditions occur in the middle of pregnancy, termination of pregnancy should also be considered and cyclophosphamide shock therapy should be administered. However, if some pregnant women with SLE who present with severe disease activity insist on continuing the pregnancy due to personal or family factors, it should be considered according to the different circumstances of individual patients. Preserving the fetus involves risking the life of the mother, while for the fetus, pregnant women with SLE who present with severe lupus nephritis before 20 weeks of gestation usually cannot be preserved and most of them will miscarry, while Once the 26th week of pregnancy is passed, there is still hope for the survival of the fetus. Therefore, doctors need to adopt different treatment methods for patients who insist on fetal preservation according to different cases. As a rule, doctors try to keep the fetus in the mother’s uterus for at least more than 30 weeks, when the probability of producing a healthy baby is about 80%. If, in the late stages of pregnancy, the mother develops pre-eclampsia, clinically manifested by hypertension, significantly increased proteinuria, and a basis for liver impairment, prompt and effective delivery measures, such as cesarean delivery, are required for the safety of the mother. In conclusion, pregnancy can induce SLE, or aggravate the disease, or cause relapse of the disease. Since the placenta produces 11-beta-dehydrogenase that oxidizes the prednisone in the maternal circulation into the inactive 11-ketone form, the mother’s administration of prednisone has no effect on the fetus, and the dose of prednisone can be increased according to the disease activity during pregnancy, while dexamethasone, immunosuppressants, and ramitoside have no effect on the fetus. Dexamethasone, immunosuppressants, radicicicol and NSAIDs have certain side effects on the fetus and should be avoided.