Rheumatoid Arthritis and Planning Pregnancy
Having rheumatoid arthritis doesn’t mean you don’t have any chances to get pregnant or that the disease could have an adverse effect on your unborn child. In fact, 70 to 80 percent of women with rheumatoid arthritis have reported that they experienced improvement in symptoms during pregnancy. It may take longer time for women with rheumatoid arthritis to conceive but it doesn’t you don't have a chance to get pregnant. Here are several guidelines to help you overcome your fears and worries:
Consideration before planning pregnancy
Consulting your doctor is necessary before planning pregnancy. It is essential that your condition is stable and under control to be able to handle the process of carrying a child. It is important that you’re able to manage the symptoms of arthritis and possible flare ups with no medication or limited medication. Because there are certain drugs for rheumatoid arthritis patients that needs to be discontinued due to possible adverse effect during pregnancy. Your body should also be physically ready to withstand the added weight that comes with the pregnancy. It is important to anticipate any problems and prepare yourself mentally and physically to overcome any difficulty.
Alter drugs taken for rheumatoid arthritis before getting pregnant
The safety of medications taken by rheumatoid arthritic patients are still vague thus the effects during conception and pregnancy is unknown. There are numerous factors to consider when altering medication like response to treatment, dependance on the medication and activity of the disease.
Nonsteroidal anti-inflammatory drugs (NSAIDs) - These drugs are not known to cause birth defects; however, it can cause kidney problems and may reduce the amount of the amniotic fluid surrounding the baby. High doses of NSAIDs have been linked to excess bleeding and prolonged labors during birth thus you may be advised to discontinue these drugs before birth. Most doctors recommended to use take NSAIDS on low doses and intermittently and avoid using it altogether in the third trimester.
Corticosteroids - Corticosteroids are another type of drug used for RA treatment. Low and moderate doses can be used safely during pregnancy. However, there are some cases that it can result in increased risk of hypertension, premature rupture of membranes and gestational diabetes. It is recommended to take the lowest dose possible, if needed.
Disease-modifying anti-rheumatic drugs (DMARDs) - There are different kinds of DMARDs and their effects also varied. Hydroxychloroquine for example, have no known risks of abnormalities in babies and it doesn’t affect fertility.
4: Evers IM, De Valk HW, Visser GHA (2004) Risk of complications of pregnancy in women with Type 1 diabetes: Nationwide prospective study in the Netherlands. British Medical Journal 328, 915-917.
Rheumatoid arthritis is a chronic inflammatory and an autoimmune disease that occurs when the immune system mistakenly attacks the body’s tissue (Rheumatoid arthritis, 2017). This disease affects the entire body, which is called a systemic (means entire body) disease. Arthritis is derived from the word part arthr-, which means “joint,” and -itis, which means “inflammation,” so altogether it means “inflammation of the joints.” It creates inflammation that causes the tissue that lines the inside of joints (synovium) to thicken. About 1.5 million people in the U.S. are affected. It affects all races, but it affects three times as many women than men (What is Rheumatoid Arthritis, n.d.). Overtime, rheumatoid arthritis causes painful swelling that can potentially result in bone erosion or joint deformity, which leads up to physical disabilities. RA can affect more than just your joints, but can spread to body systems, skin, eyes, lungs, heart, blood vessels, e.t.c (Rheumatoid arthritis, 2017).
As a doctor, I simply cannot allow for a pregnant patient to jump into a treatment, which in this case would be the prenatal dexamethasone treatment, without properly educating her on the benefits versus the risks. Though the dexamethasone treatment can help prevent ambiguous genitalia, there are slim chances and several factors that go into the treatment therapy working out successfully, there are ethical questions posed that require thorough consideration in order to achieve an ideal lifetime of fewer medical concerns for the parents of children with disorders of sexual development and the children with disorders of sexual development, there are concerns from a sociological standpoint, which lend to the ultimate decision to go in a different direction from the prenatal dexamethasone treatment, and there are the complexities of a sexual development disorder such as congenital adrenal hyperplasia.
Although there is no known prevention for this disease it recommended for the mother to follow not put the growing fetus at any harm like smoking or drinking while pregnant and to regularly have checks with the doctor.
That’s not the only rebuttal to that argument. A journal says “while children exposed to immunosuppressive drugs during pregnancy are more likely to have premature birth and low birth weight, they do not appear to be elevated risk for physical malformation or the serious side effects” (Orentlicher). Cleary, there has been research done on the risks not only these drugs can have, but other possible risks related to uterus
...heir diet during their pregnancy to treat all types of ailments. It is important to rule out any side effects, drug interactions or harm if any associated during pregnancy.
Arthritis affects people of all age groups. More than 100 types of arthritis are known. Among these osteoarthritis and rheumatoid arthritis having the highest incidence. One of the major causes of chronic debilitation in industrialized nations is Osteoarthritis which results from damage to the joints, which may be due to trauma, infection, or age-related wear. Rheumatoid arthritis is encountered less frequently than osteoarthritis and is estimated to affect around one per cent of the world’s population. Amongst patients of Rheumatoid arthritis, women are three times more likely to be affected by this condition than men. This condition is caused by an inflammatory process where the body starts attacking itself. Rheumatoid arthritis also affects several joints, with inflammation sometimes seen in and around the lungs, the heart, the eyes and the skin. The most commonly reported complaint by arthritis patients is pain. The pain might be from the joint itself and be a result of inflammation, damage from the disease, or through daily wear and tear. Muscle pain is also common and is caused by having to force movements against stiff and painful joints. Although range of movement in the affected joint may be limited and uncomfortable, physical exercise has been shown to benefit those with arthritis. Physical therapy has been shown to significantly improve function, decrease pain in the long term and delay the need for surgery in advanced cases. The majority of arthritis cases occur among theelderly, however the disease can occur in children as well. Over 70% of the population that get affected by arthritis in North America are over the age of 65 (4). The disease occurs more commonly in females than males in all races, age groups, and ethn...
It is still unknown what the cause of Rheumatoid Arthritis is but there are some theories that have not been proven. The oldest theory states that viruses and bacteria are the cause of Rheumatoid Arthritis. Now with all the research being done, scientists believe that Rheumatoid Arthritis is hereditary. Specific genes have been found to make people more likely to get Rheumatoid Arthritis. Some scientists also think that some environmental factors and infections might cause the immune system to attack. Contributing factors are smoking and being exposed to silica metal. So although the exact causes are unknown, the result is that the immune system is ready to make the joins and tissues inflamed by activating immune cells.
...t compliance, and medication adherence is highly correlated with positive health outcomes. Thus, a medicine that maximizes patient adherence, delivers the same efficacy as previously used drugs, and shows no additional adverse effects is exceedingly likely to become the drug of choice. Of particular interest to researchers currently are the medications glyburide and metformin. As more and more research continues, it is hypothesized that these drugs will become part of the pharmaceutical regime in the treatment of gestational diabetes mellitus. In fact, both glyburide and metformin have been successfully prescribed to treat GDM in other countries for several years. Glyburide, especially, is predicted to gain the approval by the FDA in the coming years as, at least, a second line medication since it has shown to only cross the placenta in insignificant quantities.
Most women are unaware of the risks associated with taking prescription medications while pregnant. Usually the fear is that of alcohol or drug use, but there is rarely any mention of prescription medications. Prescription medicine can actually be quite harmful to a fetus during pregnancy. Over the counter and pharmacy products, as well as medications prescribed by a physician previous to the pregnancy, may not always indicate potential hazards. It is important to check with a physician whether the products are safe for the baby, as well as the mother. “The U.S. Food and Drug Administration rates both over-the-counter drugs as well as medications your health care provider may prescribe. The FDA system ranks drugs as follows: Categories A through D give specific instructions on whether a specific medication is safe during pregnancy or not. The medications are distinguished by whether the benefits outweigh the risks. Category X is drugs researched and proven to cause birth defects and should never be taken during pregnancy.” (Berger, n.d.). Taking vitamins, drinking caffeine and taking other herbal supplements may...
Having Gestational Diabetes can be a significant problem in pregnancy but it does not mean that women worldwide cannot have a successful pregnancy. Having this complication means that the woman should make changes that can influence the safety of her and baby. Meaning that she should take her treatment plan seriously, following her prescribed diet, and monitoring her glucose level, followed by her prescribed medications. After pregnancy gestational diabetes should go away, the mother should continue to do exercise routines and follow a healthy meal plan after pregnancy because she still could be at risk for diabetes mellitus two.
Just as drugs such as marijuana, cocaine, and crystal meth affect the mother, it also affects the child. Babies that are born to drug using mothers are called “drug babies” and just like their mother they become addicted to the drugs causing behavior problems during their childhood. They can also have birth defects, premature birth, and are usually underweight. Babies that are born to cocaine using mothers are called “crack babies” and they face the risk of a stroke leading to brain damage. Teratogenic medications such as some antibiotics, cancer fighting medicines, blood thinners, and acne fighting medicines such as Accutane can all cause birth
There are many different areas to consider when preparing for and having a newborn. Whether the pregnancy was planned or unplanned or the couple is married or not, a newborn baby brings new responsibilities. Having a baby also forces people to make adjustments both financially and within the family. Parents also express concerns and expectations when having a newborn comma especially when it is their first; including what roles each parent and family member should play, how much confidence they have in their parenting skills, and how much financial strain would be placed on the family once the newborn has arrived. The newest issue in today’s society is the fact that many women are delaying childbirth and having more children in their later years of life.
• Your health care provider may have you take a low-dose aspirin or a calcium supplement during your next pregnancy.
Chambers, C. D., Polifka, J. E., & Friedman, J. M. (2008). Drug safety in pregnant women and their babies: ignorance not bliss. Clinical Pharmacology & Therapeutics, 83(1), 181-183.