Rheumatoid arthritis

• Auto-immune disease affecting mainly small joints and characterised by exacerbations and remissions
• Extra-articular manifestations include pleurisy, pericarditis, sub-cutaneous nodules, pulmonary fibrosis

• Characteristically improves during pregnancy with relapse in the puerparium

• Impact of disease on risk of miscarriage and IUD is controversial
• No effect on risk of pre-eclampsia, IUGR or pre-term delivery