Which medication poses a significant risk if taken by a patient with lupus erythematosus during pregnancy?

Methotrexate poses a significant risk for patients with lupus erythematosus during pregnancy due to its effects as a teratogen. Methotrexate is an antimetabolite that interferes with DNA synthesis and can affect rapidly dividing cells, which are crucial during the early stages of fetal development. Its use during pregnancy is associated with a variety of potential fetal abnormalities, including limb defects, craniofacial deformities, and central nervous system malformations. Because of these serious risks, it is crucial to avoid methotrexate in women who are pregnant or attempting to conceive.

Other medications, while they may have their own profiles and considerations, do not carry the same level of teratogenic risk associated with methotrexate. Prednisone and dexamethasone, both corticosteroids, are typically prescribed to manage inflammation and immune response, and while there are considerations for their use during pregnancy, the risks are generally outweighed by the benefits in managing lupus symptoms. Plaquenil (hydroxychloroquine) is often considered safe and is commonly used in pregnant patients with lupus to help control disease activity while minimizing harm to the fetus. Thus, methotrexate is uniquely identified as particularly hazardous for pregnant patients with