Rheumatoid Arthritis

Question 1

How do you counsel a patient with rheumatoid arthritis about the maternal risks of pregnancy?

Answer 1

• Pregnancy is usually uneventful.
• Rheumatoid joints may become unstable in late pregnancy (Undiagnosed cervical spine subluxation is a particular concern).
• Bacteremia occurring during labor, although rare, may seed involved joints.
• Antiphospholipid, anti-Ro/SSA, and anti-La/SSB antibodies are uncommon
• Fetal growth restriction
• Maternal hypertension
• Hospitalizations

Question 2

What obstetric complications are increased in patients with rheumatoid arthritis?

Answer 2

• Fetal growth restriction
• Maternal hypertension
• Hospitalizations

Question 3

What are common symptoms of a rheumatoid arthritis exacerbation?

Answer 3

increased stiffness in joints.
pain throughout the entire body.
increased difficulty doing everyday tasks.
swelling of hands and feet as well as large joints.
intense fatigue.
flu-like symptoms.

Question 4

How does pregnancy affect the clinical course of rheumatoid arthritis?

Answer 4

Pregnancy protects against the disease

Question 5

How does breastfeeding affect the risk of rheumatoid arthritis exacerbation?

Answer 5

Likely does not affect disease course

Question 6

What are common treatment approaches for pregnancy women with rheumatoid arthritis?

Answer 6

Most patients need to continue their pre-pregnancy medications, including NSAIDs, corticosteroids, hydroxychloroquine, azathioprine, and TNF-α inhibitors. Low-dosage prednisone is the safest option.

Question 7

How do the treatments for rheumatoid arthritis affect the fetus?

Answer 7

Low-dosage prednisone is the safest option of the NSAIDs, corticosteroids, hydroxychloroquine, azathioprine, and TNF-α inhibitors