Rheumatoid arthritis is a chronic autoimmune disease that affects the joints on both sides leading to cartilage destruction, bone erosion, and disability. It affects the small joints first, then progresses to the large ones and other organs. High disease severity is associated with negative pregnancy outcomes (preterm delivery, low birth weight newborn, increased cesarean sections during delivery, and pre-eclampsia) but fortunately, the disease improves in 60% of patients during pregnancy. 0.7–1% of the general population is affected with rheumatoid arthritis, which mainly affects women and is more common in those who are of childbearing age.
Morning stiffness of joints (>30 min)
Fatigue
Fever
Weight loss
Sensitive joints to pain
Joints swelling
Nodules under the skin
Visit a Rheumatologist if you have any of these symptoms for proper diagnosis, or for getting the proper treatment if you were already diagnosed and you are pregnant or planning for pregnancy now, and keep your Gynaecologist updated during follow-up visits
The main cause that makes the human immune system attack its own body causing rheumatoid arthritis is still unknown, but genetic and environmental factors contribute to the disease development.
Risk factors
Age (risk increases with age)
Female gender
Genetics
Smoking
Women who have never given birth
Air pollution
Obesity
Early diagnosis is very important as it can arrest the disease and prevent its progression in most patients. In addition to symptoms and physical examination, other tests are used to help in diagnosis including:
Laboratory tests (a sample is taken to test for the presence of disease-related antibodies, inflammatory markers levels elevation, and others).
Ultrasound imaging (a device that uses ultrasound waves is used to get an image of joints to diagnose the disease and monitor its activity).
Magnetic resonance imaging (a device that uses magnetic fields is used get an image of joints to diagnose the disease and monitor its activity).
The treatment regimen should be tailored to fit the pregnant woman, so many medications should not be used and should be stopped if they were used previously, while others can be used after consulting the Gynaecologist and Rheumatologist.
Medications:
Acetylsalicylic acid (Aspirin)
Ibuprofen
Naproxen
Prednisone
Hydroxychloroquine sulphate
Sulphasalazine
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