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Rheumatoid arthritis pregnancy planning — SCE Rheumatology MCQ

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ModeratePregnancy in rheumatic disease, rare conditionsRheumatoid arthritis pregnancy planningSCE Rheumatology

A 30-year-old woman with RA is planning pregnancy. Disease is controlled on methotrexate and hydroxychloroquine. She has no renal disease and wishes to start trying in three months. What is the most appropriate medication advice?

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

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Correct answer: C — Stop methotrexate before conception and continue pregnancy-compatible therapy

Methotrexate is teratogenic and should be stopped before conception with appropriate planning. Hydroxychloroquine is generally compatible with pregnancy and may help maintain disease control. Leflunomide also has teratogenic concerns and requires washout when relevant.

Reference: BSR pregnancy and breastfeeding guideline 2022; BNF