Pregnancy is a very special time in the life of a woman, and also their partner.
Most women at this time deepen their relationship with and care of themselves and understandably would much prefer not to take any drugs at all.
However, with many Rheumatological conditions there is a real risk of serious flares of disease in pregnancy when not taking medications and the consequences can be debilitating, if not life threatening. If the disease is not well controlled and the body is not well, then this makes it difficult to sustain a healthy pregnancy so the health of the mum-to-be takes first priority.
There are many different Rheumatological conditions, with them each having differing effects on the body in pregnancy. Its important to be well informed about your particular Rheumatological condition as it can have an impact on your ability to get and stay pregnant, depending on your condition.
It’s important to understand the medications that you are on to treat your disease, and to see whether these medications are compatible with pregnancy.
This is a great resource to read on Pregnancy and Rheumatic Diseases… Click here!
This is an educational resource, and in no way does it replace healthy and needed discussions with yourself and your treating Rheumatologist and Obstetrician.
It’s important to have a relationship with both a Rheumatologist and an Obstetrician when considering pregnancy if you have a Rheumatological condition. Because many of the drugs can have potential effects on a developing baby, there are natural concerns that a woman might have about her body and that of her baby about this time and its important to plan your pregnancy ahead in advance.
For your best health and well-being, I suggest that if you are considering having children at some stage and you have a Rheumatological condition that you plan your pregnancy well in advance. It’s important to have planning discussions with your treating Rheumatologist and Obstetrician who can support and guide you in your decision making and planning, and this will allow tailoring of your best possible management of your condition as well as supporting the best possible health of your unborn baby during pregnancy.
Below is a brief summary of general recommendations that Rheumatologists follow when it comes to medications in pregnancy.
This information doesn’t replace any personalised discussions that you would have with your Rheumatologist and treating Obstetrician to guide your personalised decision making and is a guide only as recommendations can vary.
| Medication | Use in pregnancy | Use in lactation |
|---|---|---|
| Azathioprine | Yes | Probably yes |
| Bisphosphanates eg Fosamax | No | No |
| Corticosteroids | Yes, under 20mg, avoid 1st trimester | Yes |
| Cyclophosphamide | No | No |
| Cyclosporin | Yes | Probably Yes |
| Gold | No | Caution |
| Heparin | Yes | Yes |
| Hydroxychloroquine | Yes | Yes |
| Leflunomide | No | No |
| Methotrexate | No | No |
| Mycophenolate | No | No |
| NSAIDs | Yes, but not after 32 weeks | Yes |
| Penicillamine | No | No |
| Rituximab | No | No |
| Sulfasalazine | Yes | Yes |
| TNF inhibitors: Etancercept most safety data | Yes | Yes |
| Warfarin | No | Yes |