ABSTRACT
Rheumatic disease is characterised by inflammation, with the joints, skin and kidney most frequently involved. Active rheumatic disease during pregnancy may require drug treatment to ensure the mother’s health is maintained and that there is good fetal outcome. The management aims are to relieve pain and inflammation, to prevent joint destruction and to preserve or improve a patient’s functional ability. Therapy for rheumatoid arthritis should begin with simple analgesia; paracetamol is the analgesic of choice. The use of prostaglandin inhibitors such as Non-steroidal anti-inflammatory agents (NSAIDs) or aspirin in late pregnancy may constrict the ductus arteriosus, leading to adverse fetal effects such as persistent pulmonary hypertension in the neonate and prolongation of pregnancy and labour. The fetal circulation is dependent on a patent or open ductus arteriosus, the blood vessel that allows blood to bypass the lungs. Prostaglandins also maintain the patency of the renal artery.
