Rheumatoid arthritis in pregnancy — SCE Rheumatology MCQ

Instant feedback + full explanation. One question, done properly.

EasyPregnancy in Rheumatic Disease, Rare ConditionsRheumatoid arthritis in pregnancySCE Rheumatology

A 32-year-old woman with rheumatoid arthritis is 10 weeks pregnant. Disease is controlled on hydroxychloroquine and sulfasalazine with folic acid. She stopped methotrexate 4 months before conception. Blood monitoring is stable. What is the most appropriate management?

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

Reveal the answer and explanation

Correct answer: A — Continue current pregnancy-compatible DMARDs

Explanation lettering: C = shown as B · D = shown as C · E = shown as D · B = shown as E

Continue pregnancy-compatible DMARDs with obstetric-rheumatology review is best because hydroxychloroquine and sulfasalazine are generally compatible with pregnancy and may be continued with monitoring. B is less suitable because methotrexate is contraindicated in pregnancy; C is less suitable because leflunomide is teratogenic; D is less suitable because cyclophosphamide is not used to prevent routine RA flares in pregnancy; E is less suitable because stopping hydroxychloroquine may increase flare risk without improving fetal safety. Clinical pearl: well-controlled disease before and during pregnancy usually improves maternal and fetal outcomes.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/musculoskeletal-conditions