High-Risk Pregnancy
jeanbean13
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Rheumatoid Arthritis (RA) and pregnancy
jeanbean13
member
I'm currently TTC and have RA. I've had RA for almost 7 years now. I used to take methotrexate and enbrel but have stopped taking those in order to get pregnant. Now, I am taking plaquenil, which is supposed to be safer but it still worries me.
I am wondering if there is anyone else out there who has RA and is or has been pregnant? If so, I'd love to hear about your experience.
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Re: Rheumatoid Arthritis (RA) and pregnancy
I don't have RA, but I have lupus. I was on methotrexate and plaquenil prior to getting pregnant, as well as some other things. In all honesty, other than the first few weeks when I had a minor flare due to hormone changes, I've been absolutely fine until recently.
Plaquenil is considered class B and "fine" for pregnancy. I have been lucky enough not to need it up till now, it never did a whole lot for me anyway. The methotrexate caused more side effects, but worked far better at controlling the lupus.
I did just recently start to flare (at 26 weeks), but I also typically flare at this time of year because I am extremely photosensitive and the sun is out more. Even though I don't spend a lot of time in it, just the longer days and exposure is enough to cause flares. So far, I've been able to keep it pretty well under control, but they did want me to medicate (prednisone and plaquenil) which I declined until it gets worse.
None of the regular OB's around here would see me, I was immediately referred to maternal-fetal once I moved here, and I'm in a decent sized city. You may want to call and get set up with them before you get pregnant as they can offer some advice. Mine has me coming in every two weeks, but I also have several other significant health issues.
They also told me that many people with autoimmune disorders typically fare pretty well during pregnancy, but to be prepared for a fairly large setback once LO arrives because of the hormone changes. DH is taking 10 days off to be home with me after birth, and then my mother will be able to step in if need be if I do get sick.
I stumbled on this board by accident, but I have RA. I was diagnosed 4 months PP with my son. My two subsequent pregnancies ended in miscarriage so I don't have much experience with being pregnant with RA. I do know that Enbrel is considered class B so you could continue taking it if you choose. RA typically goes into remission during pregnancy with a flare up after delivery (or so my OB and rheumatologist say).
Just wanted to wish you luck!
Hi there! I have a combined diagnosis of RA and AS (ankylosing spondylitis), a mild to moderate case. I've been on Methotrexate, Enbrel, Humira and Plaquenil at various times before getting pregnant (in my second pregnancy now). I stopped all meds before TTC with both.
We had no trouble conceiving #1, but experienced pre-term labor starting at 30 weeks (bed rest, meds and hospital stays along the way) We ended up being induced at 38 weeks. When trying for #2, I had an early miscarriage. But then got pregnant right away, once we were allowed to start trying again. With this pregnancy we started having pre-term labor symptoms at 17 weeks and it's been a rough road since (bed rest, meds, hospital stays). But we're nearing the end and baby is doing great!
My Rheumy said that most woman w/ RA go into remission during pregnancy b/c of the hormones. I did not, but I didn't really flare up either. I was just in pain b/c I was not medicated and my body, like all pg women, was going through so much. After delivery, I did flare a bit, but even then it wasn't terrible and lasted about one month. With this pregnancy, #2, I have had some pain/stiffness but I'd say less than with my first (though, I'm taking it easier b/c of all the pre-term issues starting so early, so that's probably helping).
My docs say that my pre-term labor issues may or may not be b/c of my RA/AS (helpful, right?). But in both pregnancies I've experienced advanced aging of the placenta, which apparently is often seen is women w/ auto-immune diseases. Basically, the placenta gets protein build up and starts dying off before it's time...creating an unhealthy environment for baby. I was induced at 38 weeks w/ #2 b/c of this. When I delievered, my doc said that my 38 week placenta looked to be 42 weeks. With this pregnancy, we're already seeing protein buildup on the placenta and we're closely monitoring baby to make sure it's not affecting her.
So, that's probably more than you wnated/needed to know...but I'm on bedrest with nothing better to do and remember how desperate I was for other people's experiences when we were TTC for teh first time. I hope that help and wish you the best of luck!
Thank you all for posting your responses! It's comforting to know that I'm not alone in this and I appreciate hearing from everyone.
At this stage of TTC, the most frustrating thing is that there are no clear answers when it comes to medication and pregnancy. I was told that methotrexate was an absolute "no-no" and that I needed to allow for at least 3 months for the medication to exit my system before TTC. Next, I have received conflicting information about enbrel. My old ob/gyn said that it was a category b drug and that it should be okay. However, my rhuemy said that I should stop the medication even though some doctors seem to prescribe it to help with infertility. So to be safe, I stopped taking enbrel.
Now, I'm on plaquenil because I needed something to keep my RA flare ups under control and because it's considered a safer medication to be on during pregnancy. While the plaquenil has helped, I am having all sorts of problems with my stomach. Also, it concerns me that I have to get my eyes examined every 6 months while on plaquenil. I'm tempted to go off of plaqeunil because there are some risks to fetal development and I was told by my new ob/gyn that I can't take it during breast feeding. Again, it's frustrating that there are no clear answers from the docs I talk to.
Doctors don't always keep current on research. My rheumatologist is older, and won't do ANYTHING while pregnant...like to the point that MFM told me I should try to see someone else, and in the meantime, if I need something, they prescribe it. Not that they are the be all and end all, but they are more current on research on medications and how they affect the baby, so I'm more likely to trust their opinion than some guy who looks at my hands and says "well your swelling isn't too bad this time."
Another example- current research is leaning towards triptan medications being safe during pregnancy. Most doctors will tell you "absolutely not" during pregnancy. MFM says they aren't a problem.
Depending on how much you trust your OB, I would go with what they say. You can also look up drug classes of medication online to do your own research and go from there. I did this with all of my medications before TTC to figure out what I needed to be off of and for how long before trying.
Also, as far as the methotrexate, I was also told 3 months off before TTC. Life happened, and it ended up only being 2 months I was off of it. The big concern is that methotrexate depletes your folic acid (so you should've been taking a folic acid supplement while on it anyway) and being off it for 3 months gives your body a chance to be "normal" again. I was terrified about neural tube defects because of this, but everything is fine!