Steroid injection and 27 weeks pregnant - any advice?

[ouch27]

I have rheumatoid arthritis and am also (after a long haul) 27 weeks pregnant. My symptoms have been mostly under control by taking prednisilone before and during my pregnancy. I've noticed that in the last few weeks, that I'm becoming increasingly stiffer and am finding it difficult to walk more than 30 minutes without my ankle becoming swollen and painful. I'm seeing my rheumatologist tomorrow who has said he'll give me a steroid injection which should help.

I just wondered if anyone had any experience of this in pregnancy and what effect, if any, this would have on the baby?

Thanks for reading!

No experience, but obviously some steroids are given to mature the lungs of prem babies.

Thanks lou031205. I'm not being precious but this is an IVF pregnancy after MCs etc etc and I really want to do what's best for the baby as well as keeping mobile. Just wondered what effect an injection would have in addition to the pred I'm currently on. The consultant was 'busy' and said it was 'fine'...

Steroids can be given in pregnancy - but you need to ask specifically what side effects you should look out for. Things like swelling - because obviously you don't want to have it, and then panic because you have oedema.

Thanks whomovedmychocolate. I have an appt tomorrow and I've prepared some questions that I'd like answers for. It's just getting me down being so inactive and in almost constant pain, like I can't even enjoy this long awaited pregnancy.

I know how you feel ouch27 - I have bad SPD and my pelvis is completely separated now, I can't walk for hours at a time and the pain is excruciating. BUT the good news is that I know it will end when the pregnancy does. I fear for you, this may not be the case?

Good luck today. There are some arthitis charities aren't there with helplines if you don't get your questions answered.

ouch27,
I have non rheumatoid inflammatory arthritis and had a steriod injection when I was around 25 weeks pg (I think they did it direct into my knee joint but there was a heated debate about whether it was better to do it into the bum so the steroid circulates around the whole body or direct into the joint (knees in my case) which is possibly less harmful for lo. I had to fight my rheumatologist tooth and nail for this as they had already stopped all my other meds and seemed happy for me to spend the rest of pg immobile in a wheelchair .
My obstetrician was very angry the next time she saw me and restarted the safe meds and got me a new rheumatologist who was much more understanding although they then refused to give me more steroid injections at 36 weeks as it was too close to delivery date (I wanted them to help me keep moving and deliver naturally). Obs said that lo would have absorbed "some" steroid but probably not enough to have caused any problems and that they would worry about that when lo arrived.

Have just realised you are probably already seeing the rheumatologist (if only I'd seen this last night), hope your appt went well.

Are you under consultant care for for the pg?

Good luck!

Thanks guys!
Marmitemad - seems like we have had different experiences with our respective rheumatologists. Mine was pushing me to stay on steroids for the duration and up the dose as an when required. I was the one who has been a little reluctant for fear of birth defects etc etc
I am under consultant led care for the pregnancy as am deemed 'high risk' - he's also said he's seen tons of women on steroids and is happy for me to continue on them. I still can't help but worry about my baby though...

Anyway, i had a steroid injection into my ankle yesterday which should kick in soon and after 4 weeks or so, if I'm still hobbling around, I have to double my oral dosage of steroids.

Are you currently pregnant or have you had your baby? How did things go if you've already given birth? Is it okay managing a newborn with your type of arthritis?

Sorry for all the Qs, I just don't know of anyone else who can relate.

Thanks for replying!!

ouch27,

don't worry about the Q's, I'm happy to be able to help out as I felt the same.

dd was born 10 days late in Feb last year so is now approaching 16 months and finally walking which means less carrying but more chasing on my part!

her birth was a fabulous, immensley empowering experience. I laboured and delivered upright exactly as I had hoped leaning over the bed/pulling dh's arms out of their sockets for support using only tens and g&a despite everyone's misgivings (I was told afterwards that I would not have been allowed a water birth because of the risk of my being unable to get out in an emergency but as it happened I wasn't interested on the night). I still ended up in theatre with a spinal due to a retained placenta which was unpleasant at the time but now I am just so pleased that I was able to defy the odds.

Managing afterwards was tricky at times, I found it very difficult to stand up from sitting particularly from my feeding chair while holding dd which meant we had to work out how to fit the moses basket alongside so I could put her down before hauling myself up. Getting up in the night was also difficult (and still is at times) but dh was fantastic and always got up with us to help get her ready for feeding then went back to bed. I have struggled with the tabs on disposable nappies (sometimes use my teeth!) and the poppers on baby vests/sleepsuits, so we used a mixture of leggings/tops/cardies and poppered things depending on how my hands were. It has also been very frustrating at times to not be able to sit on the floor but we can play together on the bed or sofa. I think dd has been very slower to crawl and walk possibly because I can't show her as easily.

erm can't think of anything else helpful but do let me know if you have any more questions.

Is your ankle your worst joint, were you on dmards before the pg? roughly wherabouts are you, I would be happy to meet up if you are near me? (although this is unlikely)

Marmitemad

Congrats on the birth of your DD last year! It sounds like your birth was empowering, lucky you. I'm scheduled for a c-section and really don't know how I feel about that. Part of me really wants this baby to come into the world quickly and safely as possible but I do worry about the recovery with a section and my lack of mobility with a vaginal birth,,,

As far as the RA, i haven't been treated for it as yet as I was TTC. I've been on prednisilone since last march when I was diagnosed. I think the plan is to have the baby and then start on Dmards or similar. My ankle is my worst joint right now but it does vary a lot. I've had sore elbows, knees, shoulders, hands etc etc. I'm so nervous as to how I will cope with a newborn especially as I've been told to expect a flare after 4 weeks or so. I'll have to enlist DH to help as yours did

Thanks for sharing your experiences. It's really helping and I would love to meet. Not sure where you are but we are London based?

Take care xx