gynecology and obstetrics
Autoimmune Disorders in Pregnancy
Rheumatoid Arthritis in Pregnancy
 Rheumatoid Arthritis (RA) may begin during pregnancy or, even more often, during the postpartum period. Preexisting RA generally abates temporarily during pregnancy. The fetus is not directly affected, but delivery may be difficult if the woman’s hip joints or lumbar spine is affected. Cesarean delivery is significantly more common in women who have moderate or high disease activity in pregnancy compared to those with low disease activity. Furthermore, a postpartum flare can impair the ability of women with rheumatoid arthritis to take care of themselves and their infant. . For refractory cases, other immunosuppressants may be required ( Reference ). 1.ACOG Committee Opinion No. 776: Immune Modulating Therapies in Pregnancy and Lactation.Obstet Gynecol133(4):e287-e295, 2019. doi:10.1097/AOG.0000000000003176 