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RA pregnancy planning — SCE Rheumatology MCQ

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ModeratePregnancy in rheumatic disease and rare conditionsRA pregnancy planningSCE Rheumatology

A 33-year-old woman with RA controlled on methotrexate wants to conceive. Examination shows no synovitis is present. Investigations show renal and liver tests are normal. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Stop methotrexate before conception and switch to pregnancy-compatible therapy

Stop methotrexate before conception and switch to pregnancy-compatible therapy is the most appropriate pregnancy-specific management strategy. The alternatives include teratogenic therapy, inadequate thromboprophylaxis or unsafe delay. Rheumatic disease pregnancy planning should occur before conception whenever possible.

Reference: BSR pregnancy prescribing guideline; EULAR pregnancy and rheumatic disease recommendations; BNF