Printer Friendly

Arthritis and pregnancy.

Deciding to become pregnant should be a conscious decision for all women. Since it will probably be one of the greatest decisions you ever have to make, it is important you have the information to do so. If you have arthritis and are pregnant or are thinking about having children, you may have asked yourself these questions:

* Am I ready?

* Will my arthritis go away?

* Will my child inherit arthritis?

* How will arthritis affect my pregnancy?

* How will pregnancy affect my arthritis?

* How can I plan ahead for my pregnancy?

* How can I make it easier to care for myself and my baby after birth?

The information in this booklet will help you answer these and other questions. As you read through the booklet, list the pros and cons of having a child: then, refer to this list as you and your partner make a decision. Since arthritis and pregnancy affect everyone differently, the answers to these questions will be different for everyone.

AM I READY?

Any couple who is thinking of having a baby will have certain physical, emotional, and financial issues to consider before conceiving the child. As a woman with arthritis, you will have particular concerns related to your arthritis. The self-test on p. 2 will help you evaluate your physical ability to care for a new baby. Following the test, are some questions you should ask yourself and discuss with others to help you make your decision.

Other questions for you, your family, and your doctor to consider. Any major life decision should be made at a time when you are not under stress. You need to be clear about why you wish to get pregnant and when you wish to do so. The why might be very difficult to answer, because we're all influenced by previous life experiences, current roles and relationships, and by our frame of mind. It's not uncommon, for instance, for some women to choose pregnancy when they are feeling lonely and depressed, thinking that a new baby will change things for them. You might want to ask yourself the following questions when thinking about how you feel about having a baby:

* Am I expecting a new baby to fill a void in my life?

* Do I want to get pregnant only to try to relieve some of the pain I'm having from my arthritis?

* Are there people around me who can help me when I'm not feeling well?

* Is this a good time to have a baby, personally, emotionally and financially?

If you're not sure how you feel about some of these questions, discuss your feelings with your family and friends. You might also find it helpful to talk to your doctor or other health team members. These people can also refer you to a counselor or someone specially trained to help with these issues, or to other women in similar situations.

WILL MY ARTHRITIS GO AWAY?

In some cases, pregnancy may cause some forms of arthritis, especially rheumatoid arthritis, to improve for a time. However, this does not always happen during pregnancy and should never be your reason for becoming pregnant.

Rheumatoid arthritis may improve at any time during your pregnancy. In most women, it usually improves by the end of the fourth month. While joint swelling may decrease, you may still have some joint pain or stiffness due to existing joint damage.

Lupus may stay the same, improve, or flare (get worse) during pregnancy. To decrease the chances of a flare, the lupus should be in remission for six months before you become pregnant. This means not only that you feel well, but that blood tests and other tests for the disease are also normal.

Research on scleroderma and other types of arthritis is not as conclusive. Some studies report that scleroderma flares, while others report that it improves.

If your illness does improve, it may flare two to eight weeks after your baby is born. Proper planning and treatment before, during and after pregnancy, however, can help decrease pain and swelling and help improve your ability to function. You and your health care team can work together on ways to do this.

WILL MY CHILD INHERIT ARTHRITIS?

Probably not. While the causes of most forms of arthritis are not known, some forms tend to appear in families more often than others. These types of arthritis are called "familial." Yet, heredity is never the single factor that determines if a person develops arthritis. Other factors, such as the environment (exposure to certain viruses or chemicals) also may have an effect.

Scientists have found certain genetic markers that may indicate if some people have a higher risk for getting some types of arthritis. However, the relationship between these markers and the actual development of arthritis is still unclear and does not mean you will pass arthritis on to your child. Generally, there is no way to tell if your child will ever have arthritis in the future.

HOW WILL ARTHRITIS AFFECT MY PREGNANCY?

Arthritis does not affect the actual course of pregnancy in most women. However, if you have a form of arthritis -- for example, lupus -- which affects your internal organs, such as your kidneys or heart, then it may cause some problems during the pregnancy.

As with any pregnant woman, your blood pressure will be monitored carefully throughout your pregnancy. If you develop high blood pressure, it should be treated with medications and diet. High blood pressure can be dangerous during pregnancy, so your doctor will watch closely for any problems. In some cases, the doctor may recommend you deliver your baby early.

HOW WILL PREGNANCY AFFECT MY ARTHRITIS?

The physical changes that normally occur during pregnancy may affect your joints and muscles in the following ways. (see Figure 1, p. 10).

1. Joints may become looser and less stable. This may cause you to "waddle" when you walk.

2. Knee problems may become worse due to your increased weight, or because the muscles along the side of the knee become weaker. This might cause knee pain, especially while going up or down stairs or when straightening your knee.

3. As your uterus grows, your spine curves slightly to support it. This can lead to muscle spasms in your back. Sometimes this can also cause pain, numbness and tingling in your legs.

4. Much more blood flows through your body during pregnancy, so it is important that your heart is functioning normally. If your heart is functioning normally, you shouldn't have any problems.

If you have any heart problems such as pericarditis (pare-ih-card-EYE-tiss) -- inflammation of the sac surrounding the heart -- or myocarditis (my-oh-card-EYE-tis) -- inflammation of the heart muscle your doctor may ask you to delay pregnancy until these problems are under control.

5. Water weight gain may increase stiffness, especially in your weight-bearing joints (hips, knees, ankles, and feet). It may also cause problems with carpal tunnel syndrome -- a condition that causes pain, numbness, and tingling in the thumb, index, and middle finger. This usually goes away after delivery. Report all water gain to your obstetrician during your office visit. Report any unusual water gain (any beyond the lower legs, such as in the thighs or face) to your doctor right away.

6. Breathing: Your breathing muscles will move upward due to the growing baby. This may cause only mild shortness of breath. If you have significant shortness of breath or a change in your breathing, contact your doctor right away.

DURING: WHAT TO DO ONCE YOU'VE DECIDED TO HAVE A BABY

To feel your best during your pregnancy and after your baby is born, try to get your arthritis under the best possible control before you become pregnant. This means keeping in close touch with your doctors and following your treatment program carefully before, during, and after pregnancy. Here are some ways to do this.

Visit Your Health Care Team

Your health care team must include a doctor (preferably a rheumatologist AND an obstetrician), along with any of the people listed in the following table. Work as a partner with your team members so you'll stay as healthy as possible.
Who to see        What he/she can
                    do for you
Doctors:          Can monitor your
                  arthritis and your
                  pregnancy to help you
                  plan the best possible
                  treatment program.
Rheumatologist    Specializes in arthritis.
Obstetrician      Specializes in
                  pregnancy.
Maternal fetal    Specializes in high-risk
specialist  if    pregnancies.
required)
Rheumatology      Can teach you about
nurse             pregnancy, how arthritis
                  may affect the pregnancy,
                  how pregnancy may affect
                  the arthritis, planning
                  your home environment
                  for child care, and other
                  concerns.
Nutritionist or   Can help you plan a
dietitian         balanced, healthy diet to
                  follow before, during, and
                  after your pregnancy.
Occupational      Can help you find ways to
therapist         adjust your activities and
                  your home so you'll be
                  able to care for your baby
                  with as little stress as
                  possible on your joints.
Physical          Can test your muscle
therapist         strength and joint
                  flexibility, and show you
                  how to be in the best
                  possible physical
                  condition for your
                  pregnancy.
Social Worker     Can help you with
                  financial, legal, and/or
                  employment problems
                  that may arise during your
                  pregnancy.


Follow Your Treatment Plan

You're probably already following a treatment plan for your arthritis. Once you become pregnant, you and your doctor may have to change some parts of this plan slightly. As a pregnant woman with arthritis, your plan should include:

* arthritis medicines -- know what arthritis medicines you're taking and how they will affect your baby

* exercise -- to keep your muscles strong and your joints flexible

* diet -- eat a balanced diet

* joint protection -- learn ways to ease joint pain and to reduce stress on your joints

* stress management -- to help ease the emotional ups and downs of pregnancy

Arthritis medicines: You've probably wondered whether you should continue taking your arthritis medicines. While it would be ideal to be off all medicines during pregnancy, this is not always possible. Talk to your doctor(s) about the medicines you're taking and which ones are safe to take while you're pregnant. Some medicines are used more often than others during pregnancy, and your doctor may prescribe medicines other than those listed below. Some medicines just haven't been used enough to know whether or not they'll cause problems to your baby during pregnancy. The most important concern, of course, is keeping you and your baby as healthy as possible.

Arthritis Medicines That May Be Used Cautiously During Pregnancy
Medicine      Brand-Name Examples
aspirin       Anacin, Bayer, Bufferin,
              Ecotrin
prednisone    Deltasone, Meticorten,
              Orasone, Panasol


Discuss any medicines you use -- either prescription or over-the-counter -- with your doctor(s). If you must take medicines during your pregnancy, your doctor will give you the lowest possible dose and will monitor the effect of the medicine on you and the baby. Do not start or stop taking any prescription or over-the-counter medicines without first contacting your doctor.

Taking medicines while breast-feeding: Any medicines you take may be passed to your baby through breast milk. Here are some tips to consider if you intend to breast feed:

* Talk to your doctors and to your baby's doctor about your medicines and their possible effects on your baby.

* Never take any prescription or over-the-counter medicines without first checking with your doctor or pharmacist.

* Take your medicines after the baby's morning feeding, so less medicine will be passed through your milk.

Exercise: You probably already have an exercise program to follow for your arthritis. While you'll want to continue exercising to keep your joints in their best condition, you'll also want to make sure the exercises don't harm your baby. Discuss your exercise program with your doctors before you begin, especially if you have:

* heart problems

* phlebitis -- inflammation of the veins, usually in the legs

* a serious infection

* severe high blood pressure

* high risk for premature labor

* incompetent cervix -- a problem that could cause your baby to be born prematurely

* any bleeding from the uterus

* any problems with the fetus

If your arthritis improves during your pregnancy (see p. 4), you may wish to exercise more than usual. Exercise tips:

* Practice range-of-motion exercises to help keep your joints flexible.

* Exercise to strengthen your muscles -- especially the quadricep muscles (the large muscles above your knees) -- before you become pregnant. Strong muscles will provide better support for your joints. Talk to your obstetrician about the types and amount of muscle strengthening (isometric) exercise you should do. Too much of the wrong type of exercise could reduce the amount of blood flowing to the baby, which can cause problems.

* Try walking or swimming. These are general exercises that help keep your muscles strong, increase your endurance, and are generally safe for pregnant women.

Diet: Good nutrition is very important for your health and for your baby's health. You should eat a balanced diet and practice good eating habits before, during, and after your pregnancy, especially if you are breast-feeding. A dietitian, nutritionist, or other health care worker can help you plan a balanced diet.

Arthritis may cause eating problems, due to: a reduced amount of saliva (as in Sjogren's syndrome), tooth problems, mouth sores, problems with food sticking in your esophagus, or trouble opening your mouth due to jaw pain. Also, joint pain may make it difficult to prepare meals, so you may be less likely to eat a balanced diet. If you're taking prednisone, you may need a special diet to help avoid high blood sugar which may be caused by the medication. Discuss these problems with your doctor. Below, are some ways to work around other nutritional problems that may occur.

The Problem

Weight gain or weight loss: Gaining too much weight will put more stress on your joints. The extra weight of pregnancy can make this problem worse. But if you don't gain enough weight, you and your baby may not be getting all the nutrients you both need to stay healthy.

Some Solutions

Most doctors suggest you gain between 20 - 30 pounds during pregnancy. To do this, you must balance diet and exercise. Here are some question you should consider:

* How much and what types of exercise can my joints handle? * How long can I exercise at one time?

* Are my arthritis or arthritis medicines decreasing my appetite and causing me to lose weight?

* Am I taking any medications, such as prednisone, that may increase my appetite and cause me to gain weight?

* Is emotional stress causing me to eat too little or too much?

Your obstetrician or dietitian can help you plan a diet that takes these factors into consideration. If your arthritis, for instance, prevents you from getting as much exercise as you'd like, then you will not need as many calories as someone who is more physically active. But you still will need to pay close attention to your diet, to make sure you get enough vitamins and minerals.

The Problem

Nausea and vomiting: this can lead to problems that could affect you and your baby.

Some Solutions

To prevent nausea:

* Eat small, frequent meals.

* Eat slowly and chew food thoroughly.

* Avoid greasy, fried foods.

* Eat toast or crackers when you get up in the morning.

* Avoid drinks that might upset your stomach, such as coffee and fruit juices.

* Talk to your doctor about your arthritis medicines and how they might be affecting your nausea.

The Problem

Heartburn: Heartburn usually gets worse as your uterus enlarges and pushes up on your stomach.

Some Solutions

Talk to your doctor about this and how your arthritis medicines might be affecting you heartburn. To reduce heartburn:

* Eat small, frequent meals.

* Decrease caffeine in your diet.

* Avoid fried, fatty, and spicy foods.

* Avoid carbonated drinks, such as soda.

* Raise the head of your bed by placing 6" blocks beneath it.

* If you use antacid, choose one which is low in sodium.

The Problem

Constipation: Bowels may slow down during pregnancy and cause constipation. Some forms of arthritis, such as scleroderma, also cause bowel changes.

Some Solutions

Contact your doctor immediately if you are having bloating, gas, diarrhea, or constipation problems beyond what your doctor thinks is normal for you. To relieve constipation:

* Eat high-fiber foods (whole-grain breads, fresh fruits and vegetables, cereals with bran, beans such as kidney and pinto).

* Drink 6 - 8 glasses of water daily.

* Exercise (such as walking or swimming).

* Try a high fiber laxative, such as Metamucil[R].

Joint Protection: The extra weight of pregnancy may make your joints hurt more. To avoid further damage to your joints, it's important to learn ways to protect your joints from extra stress and strain. Here are some ways to do this.

To relieve joint pain:

* Avoid pain-relief medicines, when possible. Talk to your doctor before you use any pain relief medicines and ask about exercises, heat and cold applications, and other things you can do to reduce pain.

* Use hot or cold packs on your joints. This is safe to continue throughout your pregnancy.

* Use splints. They may be especially helpful for your hands and knees. Talk to your occupational therapist or other health care worker about having splints made for you.

* Rest whenever possible. This can help relieve pain in your weight-bearing joints, such as your hips, knees, ankles, and feet.

* Try relaxation exercises, such as biofeedback or visual imagery.

* Wear comfortable shoes (such as jogging shoes) that give you good support. Shoes should have a 1" to 1 1/2" heel, good arch support, roomy toe box, and firm heel-counter.

Lace-up or velcro-closure shoes provide the most support.

* Practice good posture and gait at all times.

* Sleep on a firm, supportive mattress to reduce muscle spasms.

* Ask your obstetrician about using support hosiery to reduce fluid retention in your legs, ankles, and feet.

* Notify your doctor of any increased pain in joints and muscles and of any numbness or tingling in your hands or feet.

* Exercise to keep your joints flexible and your muscles strong (see p. 14).

If you need joint surgery, it could affect your ability to care for your baby. Consider having the surgery before you become pregnant so that you'll be able to recover before you have to care for your baby.

Stress Management: The emotional changes that ordinarily occur during pregnancy should be no different for a woman with arthritis. Your moods may range from anxiety to elation, and may be very temperamental and erratic. Discuss these emotions with your doctor, especially if they interfere with your ability to carry out your regular activities. Since some types of arthritis, such as lupus, can also cause psychological changes, your doctor should be aware of how you and your family perceive your behavior.

The following issues may also be of particular concern during your pregnancy:

Sexuality. The fatigue, nausea, and emotional changes of pregnancy often cause sexual desire and the frequency of intercourse to decrease during your first three months. Desire often increases during the second trimester, but may decrease again during the third trimester when you may feel uncomfortable and/or unattractive. Fatigue or fear of another pregnancy may decrease sexual desire after your baby is born. The additional pain and fatigue of arthritis may make these problems worse. If these changes are a problem for you, talk openly with your partner about them. Often, open communication can help solve many of these problems. You might also read Living and Loving: Information about Sex, available from your local Arthritis Foundation chapter.

Self-esteem: If joint problems, pain, or fatigue decrease your ability to care for your baby, you may feel you're an inadequate mother. This can be especially true when the arthritis flares. During these times, it's important to remember that you are capable of caring for your child, but that you may need a little more help than other people. Accepting help does not make you "less" of a mother -- it simply means you're accepting responsibility for your and your baby's well being. If you are troubled by thoughts such as these, it may be helpful to talk to someone who specializes in these problems.

WILL I HAVE DIFFICULTY WITH LABOR AND DELIVERY?

Probably not, but you'll want to find a comfortable position during the labor and delivery process. You can probably deliver your baby as most women do: vaginally, lying on your back. If this position is uncomfortable, you may want to lie on your side, or sit in a rocking chair or birthing chair. Even if you have a hip replacement, you may be able to deliver your baby vaginally, without complications.

As with any pregnant woman, you may need monitoring and certain blood tests during labor and delivery. However, the amount of monitoring you may need will depend on how active your disease is. If you have lupus or scleroderma, your fetus will probably be monitored throughout labor. In some cases, it may be necessary to check the fetus' blood during labor to determine if there are any problems that might require the baby to be born by cesarean section rather than vaginally.

AFTER: CARING FOR YOURSELF AND YOUR BABY

As mentioned earlier, your arthritis may flare after your baby is born. In many women, it often flares two to eight weeks after birth. To prevent as many problems as possible after the baby is born, you and your health care team should devise a follow-up plan for your treatment. This should include:

* visiting your doctor regularly -- to monitor your arthritis (you may also have to see other specialists, such as a nephrologist or neurologist, depending on the type and severity of your arthritis)

* resuming your exercise program -- to help keep your joints functioning (your doctor must first approve this)

* knowing which medications (if any) you should take and if you can breast-feed your baby while taking them (see p. 13)

* knowing how much activity your joints can handle and how you can pace your activities to avoid joint stress

SAVING YOUR ENERGY AND PROTECTING YOUR JOINTS

Saving energy is important for any mother. After your baby is born, you may feel fatigued more often. Some of this will be due to your arthritis, and some due the loss of sleep and extra energy required to take care of your baby.

Saving energy means performing tasks in ways that require the least amount of energy possible. You can do this by organizing tasks and by planning ahead. Here are some tips to help save energy and time while caring for your baby.

Bathing

1. Place the bathing basin so you don't have to lean over, kneel, or reach up to bathe your baby. For example, you might place the basin on the counter top next to the sink or in the kitchen sink.

2. If placed in or near the sink, fill the basin with a hose attached to the kitchen faucet. If you have hand problems, use a wash mitt to wash your baby.

3. Wear an apron with large pockets in which to place your bathing supplies. Shampoo, soap and your bathing mitt will fit nicely and can be returned to their location without you having to carry them.

4. Sit on a high kitchen stool next to the sink while bathing your baby. Other bathing ideas:

* Use a basin that has a plug to drain the water out of it, so you don't have to lift it to empty it. Use a foam rubber basin with an infant headrest, so you don't have to support the baby while bathing it.

* Place your baby in an infant car seat or table top seat for bathing.

Dressing

1. Position the dressing table at your waist height for ease in dressing the baby.

2. Choose baby clothing that is made of stretch materials and has few small buttons and snaps. Replace some fasteners or buttons with Velcro[R] fasteners. Use a button hook to button small buttons. Other dressing ideas:

* Place disposable diapers or washable diapers in large bags so you can drag them rather than lift them.

* Use a zipper pull to close zippers.

* Use shoes with Velcro[R] closure tabs so you won't have to tie a bow.

* Use disposable diapers with plastic tape tabs, or sew Velcro tabs onto cloth diapers rather than using safety pins. If you choose to use cloth diapers with safety pins, puncture a bar of soap with the safety pin so the pin will slide into the diaper more easily.

Feeding

1. To avoid stiffness during nighttime feedings, place a warm blanket over a comfortable chair before you retire. When you sit down, you can wrap the blanket around yourself.

2. Sit in a chair that has arm rests to support your arms while holding the baby.

3. If you have difficulty flexing your neck in order to see your baby, place a pillow on your lap so it will raise the baby up in your arms and out slightly so that you can see him or her. This, will also help position the arm that is holding the baby bottle. Nursing mothers can also use this position. Other feeding ideas:

* If your feet are stiff and it's difficult to get out of bed for nighttime feedings, do gentle range-of-motion exercises, especially to your ankles before rising at night. Your doctor, nurse, or therapist can show you how to do the exercises. Also, keep a comfortable pair of shoes, sneakers or slippers next to your bed.

* If you are bottle feeding and have difficulty holding your baby close to you, place the baby in an infant seat on a table.

* If you're nursing, try to lie on your side while feeding your baby rather than sitting upright and holding the baby.

* If you have problems, ask a family member to prepare baby bottles in advance, and keep the bottles in the refrigerator for the day.

Lifting and Carrying

1. When carrying your baby, place most of the baby's weight on your largest joint, such as the forearm. You may find it more comfortable to hold your baby close to you with both arms rather than with one.

2. Lift and hold your baby with your arms rather than your hands. This decreases the stress on your wrists and fingers Other lifting ideas:

* Use a lightweight stroller that is easy to push and does not require you to bend low to place your baby inside.

* Elevate the playpen on a wooden platform so you don't have to bend over as much. Be sure the legs of the playpen are firmly anchored to the platform.

* Raise the crib mattress, so you don't have to bend over to pick up your baby.

General Tips

1. Use a cart with wheels to help you move equipment around the house and to eliminate multiple trips for small items.

2. REST as much as you can. If possible, take a nap when your child does. If you need to rest while your child is awake, ask family, friends, or a hired person to care for him or her.

3. Use room intercoms so you can hear your baby when he or she is sleeping. This will save you from walking to the baby's room, frequently. Infant intercoms are available in most department stores. Other tips:

* Keep items you need during the day for the baby in the area of your home where you will be working most of the time.

* Use long-handled tongs to reach high cupboards and to pick up toys.

* As your child becomes a toddler, he or she may be able to move faster than you. To keep one step ahead of your baby, "child-proof" your home.

For example, cover electrical outlets, and put dangerous substances out of reach.

FOR MORE INFORMATION

Contact your local Arthritis Foundation chapter for more information about arthritis and related conditions. The following materials and programs may be useful:

* Coping with Pain: The Battle Half Won

* Coping with Stress: Making Stress Work for You

* Exercise and Your Arthritis

* The Family: Making the Difference

* Guide to Independent Living

* Help Your Doctor -- Help Yourself To A Better Partnership

* Living and Loving: Information about Sex

* Osteoarthritis

* Rheumatoid Arthritis

* Systemic Lupus Erythematosus

* Taking Care: Protecting Your

Joints and Saving Your Energy

* Taking Charge: Learning to Live with Arthritis

Programs:

* Arthritis Foundation YMCA Aquatic Program

* Arthritis Self-Help Course

* Joint Efforts exercise program

* People with Arthritis Can Exercise

* support groups and clubs

For information about pregnancy and arthritis from a variety of sources, contact the National Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Clearinghouse at:

NIAMS Information Clearinghouse

Box AMS

Bethesda, MD 20892

301-495-4484

THE ARTHRITIS FOUNDATION

The Arthritis Foundation is the source of help and hope for an estimated 37 million Americans who have arthritis. The Foundation supports research to find the cure for and prevention of arthritis -- and seeks to improve the quality of life for those affected by arthritis.

Formed in 1948, the Arthritis Foundation is the only national, voluntary health organization that works for all people affected by any of the more than 100 forms of arthritis or related diseases. Volunteers in chapters nationwide help to support research, professional and community education programs, services for people with arthritis, government advocacy and fund-raising activities.

Two specialized groups exist within the Foundation. The Arthritis Health Professions Association (AHPA) is composed of physical and occupational therapists, nurses, social workers, physicians and other health professionals interested in the treatment of arthritis. The American Juvenile Arthritis Organization (AJAO) is composed of children, parents, teachers and others concerned specifically about juvenile arthritis.

As a not-for-profit organization, the Arthritis Foundation relies on public contributions to fund research and provide service programs. You can become a member of the Arthritis Foundation and help support research and the fight against arthritis. Please contact your local chapter or write to: Arthritis Foundation, Membership Department, 1314 Spring St. N.W., Atlanta, GA 30309. You will receive materials about the benefits of Arthritis Foundation membership, including the bimonthly magazine Arthritis Today.

Self-test for Strength and Endurance

This test will give you a good idea of how caring for a baby will affect you physically and what p may have to work on before having a baby. Try the activities below and list any problems you have wi certain ones. Your therapist, doctor, or nurse can help you work out the problems. (Note: the weight structure of a bag of potatoes is used to mimic the motions of carrying and lifting a baby.

[TABULAR DATA OMITTED]

Having an abortion will NOT prevent a flare. Any type of delivery -- whether from a spontaneous abortion, a therapeutic abortion, or a still-birth -- could cause a flare.

Problems That May Occur in Women with Other Rheumatic Diseases

Pregnancy can be life-threatening for women who have lupus, scleroderma, or other rheumatic diseases, especially if the disease has caused kidney problems and/or high blood pressure.

Women with lupus may be at greater risk for:

* Toxemia -- a condition that may cause high blood pressure, fluid retention, and possibly seizures.

* Spontaneous abortion

* Stillbirth -- this may happen in a small number of women with lupus.

* Neonatal lupus -- a very rare condition that may cause a lupus- like rash in some newborns. The rash usually goes away within six to twelve months after birth. Some babies may also develop congenital heart block. This is a malfunction in the electrical system of the heart, which causes a slow heartbeat. If this problem is severe, a pacemaker may be inserted in the baby. In most cases, these infants do well and have no further problems.

* Slowed growth of the fetus -- a common problem that your doctor will monitor. If this problem becomes severe, you may have to deliver your baby earlier than planned.

Your doctor may perform the following blood tests to assist him or her in planning the frequency and type of evaluations you may need during your pregnancy.

* Anti-cardiolipin (AN-tie car-dee-oh-LIE-pin) antibody test: a test associated with an increased risk for miscarriage.

* Anti-Rho (SSA) and Anti-la (SSB) antibody tests: tests associated with an increased risk for congenital heart block in the baby.

* Lupus Anticoagulant (AN-tie-koe-AGG-you-lant): a test associated with an increased risk for spontaneous abortion.

If you have kidney problems, such as with lupus or scleroderma, your doctor will monitor these problems and perform tests more frequently during your pregnancy. Sometimes it is difficult to tell the difference between kidney problems caused by the illness, or pre-eclampsia (toxemia) caused by the pregnancy. If there is a chance that your kidney problems may improve or go away, your doctor may ask you to delay your pregnancy until these changes occur.

Always discuss any problems with your doctors and health care team. They can help you work around the problem, so you and your baby will be as healthy as possible.

Do not drink alcohol to control or ease pain. Alcohol may harm your unborn baby.
COPYRIGHT 1990 Arthritis Foundation, Inc.
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1990 Gale, Cengage Learning. All rights reserved.

 
Article Details
Printer friendly Cite/link Email Feedback
Publication:Pamphlet by: Arthritis Foundation
Article Type:Pamphlet
Date:Dec 1, 1990
Words:5456
Previous Article:Fibromyalgia (fibrositis).
Next Article:Basic facts: answers to your questions.
Topics:

Terms of use | Privacy policy | Copyright © 2018 Farlex, Inc. | Feedback | For webmasters