|
Rheumatoid Arthritis is
a disease that occurs more in women usually of childbearing age than
in men. It is a systemic, chronic, autoimmune inflammatory disease.
The problem with this disease is felt mostly in the joints area
Rheumatoid arthritis and pregnancy seem to have a connection based on
medical observations and studies. During pregnancy, development from
the disease can be observed. The symptoms and effects of rheumatoid
arthritis lessen at the period of bearing a child. Studies have
confirmed that improvements from the said condition can be experienced
by a pregnant woman suffering from rheumatoid arthritis. Experts
conclude several theories regarding this matter. Here are some of
them: during pregnancy, hormonal changes take place. An example is the
level change of cortisol, estrogen and progestin; pregnancy also has
an effect on the cell-mediated immunity like the predomination of
helper T-cell 2 (TH2) cytokine profile; pregnancy affects humoral
immunity in which a proportional decrease in the immunoglobulin G
lacking terminal galactose units can be observed and there is the
development of anti-HLA class II antibodies too; there is decreased
neutrophil respiratory burst during pregnancy because of the altered
neutrophil function; the elevated levels of anti-inflammatory
cytokines such as interleukin-1 receptor antagonist (IL-1Ra) and
soluble tumor necrosis factor as well as the down regulation of Th1
cytokines during pregnancy; the degree of HLA disparity between the
mother and the fetus also has an effect. The more genetically
different the mother and the fetus are, the more chances that
rheumatoid arthritis will dispatch.
The sad truth about rheumatoid arthritis and pregnancy is that even
though improvements from the disease can be observed during the stage
of pregnancy, a large percentage of these patients go back to having
the active disease after giving birth. Sometimes, the disease even
worsens. The changes in the disease during pregnancy are just
temporary and very short-lived so most patients suffer from postpartum
symptoms. The possible causes of this are the decrease in the
anti-inflammatory steroid levels after giving birth, elevated levels
of prolactin which is a pro-inflammatory hormone, change in the
neuroendocrine axis and change from a TH2 to a helper T-cell 1
cytokine profile.
Rheumatoid arthritis however has no significant contribution to
maternal morbidity during pregnancy and labor. Studies and clinical
experiences have shown that the delivery of pregnant women with
rheumatoid arthritis is comparably the same with pregnant women who do
not have the disease. Rheumatoid arthritis is said to have no adverse
effect too when it comes to the fetal development or fetal morbidity.
It also does not affect the fertility of the patient. The only
observable effects are the prolonged time to conception, decreased
sexual drive, pain and an ovulation dysfunction.
The common discomforts that are felt during pregnancy are somehow
similar with the symptoms of rheumatoid disease like fatigue, swelling
of the hands, feet or ankles, joint pain especially in the low back,
shortness of breath and numbness or pain in one or both hands.
The treatment for rheumatoid arthritis during pregnancy needs
supervision from both the rheumatologist and the obstetrical provider.
This is because some medications used in the treatment are not safe
and advisable during pregnancy. Constant meetings with the specialists
are needed when undergoing the treatment in which the blood pressure
is always measured and the urine is tested. After 10 to 12 weeks of
pregnancy, the heart rate of the fetus will be measured too at every
visit.
Because of the possible worsening of the disease after pregnancy and
the risks of affecting the child during medication, married women with
rheumatoid arthritis are advised to prepare themselves first before
they decide to get pregnant so as to avoid more problems and
complications.
|
