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I have rheumatoid arthritis. Do I need a high risk OB? Any suggestions for specialists in autoimmune disorders and pregnancy.
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He doesn't think it's a foregone conclusion. My regular OB/GYN gave me a referral for an MFM specialist, though she's at Beth Israel and a friend had a really bad experience there. I'm looking elsewhere, and wondering if anyone out there has a subspecialty in autoimmune diseases. Anyone else out there w/ RA...what did you do?
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I have RA- had two pregnancies- luckily in both I was great with no meds but fish oil. Went to high risk after reading study that suggested RA patients had higher rates of preeclampsia (though not that much higher) and pretty significantly higher rates of IUGR. Had more monitoring at the end because of the increased IUGR risk and also was not allowed, by my high risk doctor, to go more than 41 weeks because she said there was risk of placenta detrioration beyond the normal amount when you go past the due date. My rheum said high risk wasn't necessary, but another rheum I saw during pregnancy (that had privileges at the hospital I was delivering at) thought it was a wise move. Lupus pg's are obviously more high risk and I think anyone with lupus would see a MFM, so you might find a doctor who sees moer lupus patients but I don't think that it's all that relevant to RA in pregnancy. Good luck!
[ Reply | More ]That's great you were in remission. I'm new here - what's IUGR? Are you in NYC? If so, do you recommend your high risk OB? Also, were you on any TNF meds prior to conception? How before trying did you go off? This is one thing that I can't seem to find anything resembling consensus on...For MTX it's 3 months, but that is a LONG time to go w/o anything...Thanks.
[ Reply | More ]OR here- I was on Kineret, a biological but not a TNF inhibitor. I dropepd to only Kineret and fish oil, stopped NSAIDs and plaquenil and sulfaslazine. My rheum said the Kineret left my system so quickly that he said I coudl take up until a positive home pregnancy test. SO I always tested super early. Ended up needing IVF, so I actually stopepd the Kineret two days before egg retrieval.
[ Reply | More ]With pg number 2, got pregnant naturally first month trying, tested super early and got the faintest positive about 9-10 days after ovulation, and stopped kineret then. My RE, OB, and Rheum never had a probalem with just staying on Kineret and stopping it super early in the pregnancy.
[ Reply | More ]on my second pg, it happened naturally, I was on Kineret while trying and stopped it at 9-10 DPO when I got the faintest positive on a pg test. RE< OB< and rheum never had issues with me being on Kineret while trying.
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I have RA, and intentionally went off Remacaid to get pregnant. Tried a # of times earlier, but couldn't last off meds for 3 mos. Over 40, severe RA, did not need a high risk OB (even though I hit that category in 2 areas; age and disease). Textbook pregnancy, pain free for 9 months, and back needing meds nearly a week after I gave birth. She's beautiful, smart and worth every bit!!! GL!
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