Pregnancy despite rheumatism

What women with rheumatism should consider when pregnant

07/17/2014

Women who suffer from rheumatism are often restricted in everyday life. In order to get the complaints under control, they are usually dependent on strong drugs for a lifetime. While doctors of previously affected women have often advised against pregnancy, women today can in many cases fulfill their wish for children despite rheumatism. Anyone who wishes to have a baby should plan the pregnancy well. The news agency „dpa“ Talked to a rheumatism patient and doctors about possible problems and their solutions to rheumatism.

Certain medicines for rheumatism can damage the unborn child
There are about 300 different rheumatic diseases known, the course and severity of which varies greatly from each other. So rheumatism can affect the joints and bones, the muscles, the organs, the connective tissue and the vessels. Metabolic disorders such as gout are also associated with rheumatic complaints. Worldwide, 0.5 to 1% of the population is affected by rheumatoid arthritis, which is characterized by inflammation of the joints. Women are three times more likely to be affected than men, with about one-fifth receiving the diagnosis before the first pregnancy.

Maria Krauser became ill at the age of four, suffering from an early form of rheumatoid arthritis. Since then, the now 32-year-old suffers from the painful inflammation of the joints, which deformed over the years in part. To curb the symptoms, the young woman takes long-lasting medications, including methotrexate (MTX). The remedy is embryo-damaging and therefore should not be taken during pregnancy. At the age of twenty, Maria Krause wanted a child. But what medicines could she take during pregnancy, which kept the disease at bay and did not harm the child??

Sometimes caesarean section is necessary for rheumatic patients
After a thorough consultation with her doctors, the young woman lost MTX and took, among other things, a low-dose cortisone preparation. „Fortunately, I did not get any illness, "she told the news agency. „The first pregnancy went well, I felt fit and did not take too much. "Her first son was born in Caesarean section in 2009. „I got an artificial hip in 2007 and did not want to take the risk of having something happen at the joint during birth. "

As Christian Albring, president of the professional association of gynecologists, explained to the news agency, but not every rheumatoid patient will get a caesarean section. With a very weak musculature or a severely affected spine and hip, however, a planned caesarean section would be better.

In 2010, Maria Krauser again had to undergo a hip operation, in which the second hip joint was replaced. She continued to take no MTX because she wanted another child. Her second son was born three years later. „At the second pregnancy and after the birth everything was stressful, "says the 32-year-old.

In the meantime, Maria Krauser has found a good place in her everyday life with the illness and two small children. She advises voluntary women and young rheumatism patients for the Rheumatism League. She also looks after the group „Family despite rheumatism - the slightly different discussion group ". „There is a lively exchange or even tips on how to lift, carry or wrap the children, for example, in spite of joint problems, "says the young woman. „With a good network and good advice, a life with rheumatism and family is great. "

Can rheumatism drugs be taken during pregnancy?
Pregnancy and rheumatism are no longer mutually exclusive today. „In the past, these women were often advised against having a child. This is no longer the case today, but pregnancy and the time thereafter should be planned as optimally as possible, "explains Rebecca Fischer-Betz of the German Society for Rheumatology (DGRh) to the news agency, according to some studies more frequent in women with rheumatoid arthritis In addition, the risk of premature births is increased and there is an increased incidence of so-called pregnancy poisoning with a strong increase in blood pressure during childbirth, reports Albring. „That's why we will monitor these women closely. "

The pregnancy also has a positive effect on rheumatism. About half of the patients experience pain and joint swelling while pregnant, due to the hormonal changes. After birth, however, it often comes to a new disease, said Albring. Then often stronger drugs are needed. Rheumatoid arthritis often occurs in spurts. „I recommend that you treat pregnancy in a phase where rheumatism is stable, "advises Fischer-Betz.Pharmaceuticals that do not harm the child should be continued during pregnancy to reduce the risk of relapses and pregnancy complications.

Alternative to strong rheumatism drugs during pregnancy
The rheumatologist, who works at the University Hospital Dusseldorf, emphasizes that it is very important to sell MTX and certain other medications. MTX should not be taken at least three months before conception. This and other remedies can cause severe birth defects in the child. „We assume that the risk of skeletal malformations is six to eight percent if MTX was taken during the first few weeks of pregnancy, the risk of miscarriage is around 40 percent, "explains Fischer-Betz Risk of malformations at about three percent.

For ten to 20 years, so-called TNF-alpha blockers are on the market, which may be taken instead of MTX. „We have an overview of about 1000 pregnancies from case series and registries, in which TNF-alpha-blockers were taken in the early stages of pregnancy, there is currently no evidence of increased malformations, "says the doctor. „But we would like to have even more security to make clear recommendations.“