Taking Medicine For RA And Fever. Tested Positive For Pregnancy. Safe To Continue Pregnancy?

Posted on Wed, 6 Mar 2013

Question: Hello doctor, my wife,age 38 years ,is suffering from RA since last 10-11 months.She had a fever for a week last year in march -april and during that time she started feeling lot of pain in fingers and legs and even she was not able to walk due to severe pain in legs. then we met our family doctor and she suggested to consult with rheumatologist. rehumatologist suggested for some test, at that time her hemoglobin level was low and ASO titer was positive after initial test. then doctor said that my wife is suffering from RA and she may have to take treatment for 12- 18 months. doctor suggested to take HCQS AND DFZ-6 tabs along with hifnac and antacid tab. since then she is on medication on all these tabs. gradually doses have come down...but now there is another problem started. her eyesight is getting poor and affected. she feels dizziness and feeling very week. stamina has come down drastically and she feels that entire body is very week and feeling very lethargic. hifnac has been stoped since 2-3 months by doctor . we did not plan for second child but now we came to know in XXXXXXX 13 that she is pregnant and its more than 2 months that she is pregnant. Please advice is it good to deliver 2nd baby at this time...? will these tablets have side effect on new baby. if yes then what other tablets should we take. ? will there be complications as its 2nd pregnancy at the age of 38-39 ......? also tell us..how long these RA treatment will continue. ? what extra precautions does she need to take if we decide to go for pregnancy ...? should we go for abortion if its not safe for baby at all ....? this is her second pregnancy . plz give advise to take informed decision. one more thing we did not plan for this pregnancy. recent test also indicate high ESR levels.....what medications or teblets she should take to increase stamina...reduce weekness,feel better overall.

Answered by Dr. Divya Agarwal (6 hours later)

Hi,

Thanks for the query. You seem to have multiple queries related to pregnancy. I shall provide you with a summarized answer to all your queries as:

Now that your wife is pregnant, she may continue pregnancy. But it would be a high risk pregnancy considering her present problem and her age. However the positive aspects are that hcqs is generally safe during pregnancy.

The reason why she may be feeling weak, may also be due to her pregnancy and anemia; and not necessarily the arthritis. Because the arthritis generally goes into remission once the patient is pregnant and generally flares after delivery. So in most instances we are able to stop medication during pregnancy and restart it after delivery.

She will however need to start taking supplements of folic acid and iron as the obstetrician advises and go for regular ultrasound scans.

Hope I have answered all your queries. Let me know if I have missed out on any of your concerns.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Divya Agarwal (15 hours later)

Hi Doctor,

Thanks for reply.

You have mentioned that considering her age and problem,it would be a high risk pregnancy. Please explain or tell me more as what exactly that mean ? What kind of problem or complications she may face ?
if problems or complications chances are very high then shall we think of abortion ( its 2 and half month now) .....? because we already have one healthy 4 year old son. actually i want to avoid abortion because i have heard that abortion will affect her health badly in long run....is that correct...?

I have also mentioned that she is taking DFZ6 a day. will consumption of DFZ6 affect health of baby ? and for how long does she actually need to take this medication ?

Another thing you have mentioned is that arthritis generally goes into remission once the patient is pregnant......i did not understand this part. please give some more information on this.

Please suggest me also if we go for this second child then can she do yoga ?

What kind of diet plan should be followed if she go for second pregnancy.

I am sorry i have asked many things at one go...but at this moment we are specially i am very worried and afraid.
One more thing want to tell you is that her 1st delivery was normal at age of 34, If we go for this 2nd pregnancy at age of 38 then what are the chances of normal delivery and after the birth ...will this pregnancy effect her health condition overall.

Please reply soon.

Answered by Dr. Divya Agarwal (9 hours later)

Hi,
What I meant was that she is above 35, which need to be taken into consideration by being cautious; it does not mean that it is going to produce problems.
Defza 6 mg is generally safe in pregnancy, with a slightly increased risk of cleft palate in child, which is correctable by surgery.
She can do yoga but mild exercises.
There is no special diet she needs to follow.
The disease going into remission means that she should not have any swelling or pain in joints.
The risk in pregnancy is mild, as she has not been taking any teratogenic drug like methotrexate.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Divya Agarwal (13 hours later)

Hi Doctor thanks for your reply.

Please tell how long that RA treatment may go . months or a year or more...?

what are the chances of normal delivery ?

as of now as per 1st sonography done on 27th XXXXXXX doctor said baby is ok.

plz tell Are there any test which can be done to check any kind of problems in baby and overall health and growth of baby.

Answered by Dr. Divya Agarwal (9 hours later)

Hi,
Generally, the treatment for RA goes on life long.

RA should not affect chances of normal delivery.

There are various tests available like triple test and other tests to check b HCG, your obstetrician should be able to advise you for the same according to the weeks of pregnancy.

Regards,

Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Shanthi.E