Pregnancy, fertility and arthritis Drugs, breastfeeding and supplements

When planning a pregnancy it is important to have early discussions with your rheumatology team, either with your consultant or specialist nurse. Together they will look after you before, during and after pregnancy. It is important to be as prepared as possible before getting pregnant. This is called the British Society for Rheumatology Biologics Register – Rheumatoid Arthritis (BSRBR-RA).

  • It’s going to be difficult, but if you plan ahead, make informed decisions and do what’s right for you, you’ll be great.
  • Your dose of diabetes medication may then need to be adjusted.
  • Amitriptyline is fine to take throughout pregnancy and should also be fine to take at a low dose during breastfeeding.
  • It’s recommended that all pregnant women have at least two ultrasound scans.

To improve the outcome of your fertility treatment, it’s recommended that you continue taking your anti-rheumatic medication that’s pregnancy safe. Once I found out I was pregnant, had notified my GP and spoken to a midwife, they referred me to the obstetrician, Lucy Morse, who I previously saw in the lupus pregnancy clinic. In addition to the routine 12- and 20-week scans, I had scans at 24, 28 and 32 weeks.

Test for anti-Ro antibodies

Discuss any plans for fertility treatment with your rheumatologist. Most women with arthritis are fine to have fertility treatments if their condition is under control. Your arthritis is unlikely to affect your fertility, this is your ability to get pregnant.

Your doctors will tell you when to stop it, either before labour or a planned Caesarean section. Many medications used in women with lupus are safe to use in pregnancy. Having a pre-pregnancy appointment with your rheumatologist and an obstetrician means you can discuss the safety of the medications you currently use.

Restarting your medication

This is important because some antibodies (called Ro & La) carry a small risk of causing heart block (a very slow heart rate) in babies. This risk can be reduced by taking hydroxychloroquine, so it may be necessary to start this treatment early. We have lots of experience with the medications we use both during pregnancy and after when you are breastfeeding. We will make a medication plan with you, for each step of the pregnancy and after the birth of your baby.

So, your baby will be getting a boost to their immune system every time they breastfeed. In the first few feeds you’ll produce a thick yellowish fluid called colostrum. This is packed full of antibodies that will boost your baby’s immune system and protect them from harmful bacteria and viruses.

Should I take drugs during pregnancy?

Versus Arthritis is supporting research into the use of vitamin D supplements during pregnancy. A follow-up trial is underway, which aims to test whether this improved bone mass from vitamin D supplements continues into childhood. But because it’s not harmful to pregnant women, it’s unlikely to be harmful to men hoping to father a child. You don’t need to make the final decision until the baby is born, but it’s never too early to start thinking about it.

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This will reduce the chances of any complications during the pregnancy and will make flares less likely immediately after the birth. New medications and new data about the safety of medications in pregnancy is coming out all the time. It is always best to discuss your medication with your team and plan their use safely. These include mycophenolate mofetil (MMF), warfarin and methotrexate.

A high dose of inhaled steroids can sometimes cause more serious side effects but this is rare. Corticosteroids are powerful medications that can sometimes have side effects. We were at home for 12 lovely hours, but then Elfie changed position and I ended up being rushed to hospital for an emergency C-section.

Pregnancy, fertility and arthritis

2 in 10 pregnant women with lupus develop pre-eclampsia, compared to 1 in 10 the general pregnant population. Women with pre-eclampsia have high blood pressure and protein in their urine. Symptoms usually start after week 20 of pregnancy and can include swelling, headaches, changes in vision, shortness of breath, feeling and being sick and stomach ache. Keeping lupus well controlled in the 6 months before getting pregnant and continuing medications which have been recommended by your team helps avoid flares in pregnancy.