How to Treat Rheumatoid Arthritis during Pregnancy
October 10, 2018
For most women, rheumatoid arthritis usually improves during pregnancy, relieving symptoms from the first trimester of gestation, lasting up to about 6 weeks after delivery.
However, in some cases it is still necessary to use medicines to control the disease, being necessary to avoid medicines like aspirin and Leflunomide. In addition, most of the times, after the baby’s birth, the woman also goes through a worsening arthritis, which lasts about 3 months until stabilizing.
Risks for Pregnancy
In general, if the disease is well controlled, women suffering from rheumatoid arthritis have a calm pregnancy and the same risk of complications as healthy women.
However, when the disease worsens in the third trimester of pregnancy or when corticosteroids are needed, there is an increased risk of developmental delay, premature delivery, bleeding during delivery, and the cesarean delivery is needed.
Recommendations before and during Pregnancy
Some care should be taken by women with rheumatoid arthritis to have a quiet and healthy pregnancy with maximum control of the disease:
Before Getting Pregnant
Before pregnancy the woman should talk to the doctor and evaluate the best way to control the disease and have a healthy pregnancy, and it is usually recommended to stop using medications such as Methotrexate, Leflunomide and anti-inflammatories.
During the Pregnancy
During pregnancy, treatment is done according to the symptoms presented, and it may be necessary to use corticosteroids such as prednisone, which in low doses can control arthritis and is almost not transmitted to the baby.
However, long-term use of this medication often increases the risk of infections during labor, and antibiotics may be needed even during or shortly after labor.
After the baby’s birth, rheumatoid arthritis worsens, and it is important to talk to your doctor about the best treatment.
If there is a desire to breastfeed, medications such as Methotrexate, Leflunomide, Cyclosporine and Aspirin should be avoided as they pass into the baby through breast milk.
In addition, it is important for the woman to receive support from the family and the partner to help with the tasks with the baby and to overcome the grise phase of arthritis more quickly and calmly.