Pregnancy and Arthritis.
Last updated Tuesday, January 04, 2005
Common questionsWill arthritis go away during pregnancy? Rheumatoid arthritis
may improve at any time during pregnancy. In most women, it usually
improves by the end of the fourth month. While joint swelling may
decrease, pregnancy women 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 illness does improve during pregnancy, 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.
Having an abortion will NOT prevent a flare. Any type of
delivery--whether from a spontaneous abortion, a therapeutic abortion,
or a stillbirth--could cause a flare. Will the child of a woman with arthritis 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 does arthritis affect pregnancy? The physical changes that normally occur during pregnancy may affect joints and muscles in the following ways.
- Joints may become looser and less stable. This may cause a pregnan woman to "waddle" when she walks.
- Knee
problems may become worse due to 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
the knee.
- As the uterus grows, your spine curves
slightly to support it. This can lead to muscle spasms in the back.
Sometimes this can also cause pain, numbness and tingling in the legs.
- Much
more blood flows through the body during pregnancy, so it is important
that the heart is functioning normally. If your heart is functioning
normally, there shouldn't be any problems. If you have any heart
problems such as pericarditis (inflammation of the sac surrounding the
heart) or myocardltis (inflammation of the heart muscle) your doctor
may ask you to delay pregnancy until these problems are under control.
- Water
weight gain may increase stiffness, especially in 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 beyond the lower legs, such as in the thighs or face
to your doctor right away.
- Breathing: The 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.
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