Pregnancy does not cause gout, but it does make the condition worse. Gout is an inflammatory joint disease that affects older individuals causing various debilitating symptoms.
Pregnancy does not cause gout, but it does worsen the condition. Gout is an inflammatory joint disease that rarely occurs in women in their reproductive years.
In this article, you will learn about gout in pregnant women. We will discuss the risk factors, symptoms, and how it is diagnosed. You will also learn about how women can treat gout to ensure a healthy pregnancy. Finally, we’ll answer commonly asked questions to help you fully understand gout during pregnancy.
What is Gout?
As defined by Mayo Clinic, Gout is a complex and common type of arthritis that anyone can experience. The condition is characterized by pain that manifests severely and suddenly. A person with gout also experiences tenderness, swelling, and redness in the joints. Patients are commonly affected in various joints and on the big toe.
Can Pregnancy Cause Gout?
Pregnancy does not cause gout, however, the condition does worsen in these types of cases. Different from other rheumatic conditions, gout rarely happens to women who are of childbearing age.
Risk Factors for Developing Gout During Pregnancy
There are several factors for developing gout whether or not you are pregnant. Some are related to lifestyle choices while others are based on your medical history and genetic predispositions.
Uric Acid Levels
Hormonal changes that occur during pregnancy may cause elevated levels of uric acid. Other factors for excessive uric acid levels include dehydration and a diet high in purine. Obesity is also a contributing factor to having high uric acid levels. The risk of having elevated levels of uric acid also increases with age, which is why gout is more common in older individuals.
Diet High in Purines
Foods high in purine can increase the production of uric acid. Purine-rich foods include seafood, meat gravy, liver, tuna, yeast, mushrooms, legumes, beer, and other items. These types of foods must be eaten in moderation with plenty of water to help the uric acid to stay under control.
It is important to note that not all individuals with elevated uric acid levels will develop gout. At the same time, some people who have gout do not present with high levels of uric acid when not under attack. Thus, each case has to be treated individually and the person as a whole has to be assessed thoroughly.
Pre-Existing Conditions
Several pre-existing conditions cause gout including diabetes, kidney disease, hyperuricemia, metabolic syndrome, and high blood pressure.
Symptoms of Gout During Pregnancy
Symptoms of gout in pregnant women are similar to those that present in non-pregnant patients. Not all patients have the following symptoms as each person is unique and will experience a unique set of symptoms.
Sudden and Severe Joint Pain
One of the main symptoms of gout is sudden and excruciating pain, often on the big toe or other joints. This debilitating symptom can impact a person’s ability to stay mobile and do daily activities. Some patients experience mild pain, but during a gout attack, the pain is more commonly extremely severe and debilitating. A person who experiences a usual gout attack is not able to carry out normal functions of their body.
Joint Swelling
The big toe or joints can become visibly swollen, which is an indication of significant inflammation. This symptom is partly due to an accumulation of synovial fluid in addition to systemic inflammation. Swollen joints contribute to pain and limited range of motion, which can become chronic and worsen over time if not treated timely.
Redness and Warmth
Gout inflammation causes the affected joints to become red or purple both in acute and chronic cases. You may also notice that the joints become warm to the touch, even when inflammation is not present. It is important to know that not all patients experience redness and warmth accompanied by inflammation, thus, symptoms must be assessed on a case-by-case basis.
Tenderness
The joints or big toe may become tender, making it difficult to walk or exercise normally. When gout becomes chronic, the individual is likely to develop frequent joint tenderness, which makes it difficult to stay in shape and lead a normal life. This is an even a more serious problem for pregnant women who already have special needs during their nine months of gestation.
Limited Range of Motion
Because of the painful and uncomfortable symptoms that an individual experiences with gout, it is common for the person to have a limited range of motion. There are therapeutic exercises that can alleviate this physical limitation. It is especially important for pregnant women to engage in a physical therapy program when diagnosed with gout. Normally, pregnant women have mobility challenges due to the normal weight gain that the growing fetus demands. By having a regular exercise program, pregnant women with gout can experience a more comfortable and safer pregnancy.
Joint Stiffness
Gout flare-ups can cause stiff joints. These episodes can be triggered by physical trauma, medications, certain foods, and other factors. The relief of stiff joints is achieved by nutritional changes, warm and cold compresses, medications, therapeutic exercise, and other modalities.
Intense Burning Sensations in the Muscles and Joints
Gout pain is severe and characterized as a burning sensation that is very uncomfortable. There are medications that help relieve the pain and the uncomfortable burning sensation to help the individual regain the best musculoskeletal functionality. It is more beneficial to deal with symptoms early before they become highly debilitating and prevent the person from engaging in normal daily activities. Gout is a disease that requires steady management so that it doesn’t progress, causing further limitations of the musculoskeletal system.
Fever or Chills
Since a gout attack causes systemic inflammation, it may also cause fatigue and malaise, which can often be accompanied by fever and chills. It is rare for a person to experience these symptoms, but if a person could experience fever or chills, it could be an indication of a compromised immune system. It is particularly important for pregnant women to manage gout symptoms well in order to prevent severe gout attacks from occurring.
Diagnosing Gout During Pregnancy
The best way to diagnose gout is for a healthcare team to focus on a combination of assessments which include observing a person’s anecdotal accounts of their condition. Additionally, there are many medical tests that serve to help doctors properly diagnose gout in both pregnant and non-pregnant individuals.
Blood Tests to Check Uric Acid Levels
Serum uric acid levels are one of the most important factors in determining if a pregnant woman has gout as well as those individuals who are not pregnant. Effective diagnostic blood tests should also include the analysis of joint (synovial) fluid. These tests help to detect the possible presence of uric acid crystals in the joints. Serum uric acid tests should also be part of the necessary ongoing tests to help individuals with gout stay healthy and be able to enjoy normal mobility.
Imaging Tests such as X-Rays or Ultrasound Scans
Gout is a disease that presents in various stages. Thus, imagining tests are not commonly performed at the beginning of the diagnosis process. Instead, they are generally done as the disease progresses.
These tests are helpful in assessing the damage the joints have endured from chronic gout attacks. As time goes on, the chronic inflammation and limited range of motion put a significant amount of strain on the joints. The damage can be possibly seen in X-rays and ultrasound scans. The results of these diagnostic tests serve as an essential component in crafting an effective gout management care plan.
Treatment Options for Gout During Pregnancy
Dietary Changes
Changing nutritional habits significantly helps pregnant women recover from the debilitating symptoms of gout. New food habits can help individuals enjoy a higher quality of life and prevent gout symptoms from becoming worse. One of the most useful changes in one’s nutrition is drinking more water.
It is important to stay hydrated by drinking purified water that comes from a quality source. In addition to being fully hydrated, it is key to eat a diet that is rich in nutritious meals while being low in foods that have a high purine content. A healthy gout diet requires plenty of whole grains, fruits, and vegetables, plus a moderate amount of protein intake.
Sugar should be avoided and caffeine should be consumed moderately. Alcohol is certainly a substance that gout patients should not consume, especially pregnant women. By making nutritional adjustments, individuals who have gout are likely to see beneficial changes in their condition.
Low-dose Aspirin
Pregnant women need to take low-dose aspirin under careful medical monitoring, especially during the first and third trimester. Aspirin helps relieve inflammation and pain, however, the National Library of Medicine has concluded that low-dose aspirin use may be associated with a higher risk of recurrent gout attacks. There are other medications that can help pregnant manage gout symptoms without the risk that low-dose aspirin has.
Cold Compress
Using a cold compress helps pregnant women relieve joint inflammation, warmth, and redness. It provides a temporary soothing sensation when experiencing a gout flare-up. Cold compresses can also help relieve the burning sensation on the joints that sometimes presents with gout.
Rest
Rest is very important for patients with gout, especially women who are pregnant. It is recommended to elevate the feet to help relieve inflammation from the legs. Pregnant women generally need more rest to relieve tension from the added weight on their joints. Those with gout will need additional rest to ensure joints stay mobile and comfortable.
Paracetamol (Acetaminophen)
Acetaminophen is safer for pregnant women than other pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs). It helps relieve pain and reduce inflammation, allowing the woman to regain range of motion and comfort. WebMD reports on studies that found approximately two-thirds of women in the United States take acetaminophen during their pregnancy. As long as the doctor gives you the okay to take this medication, you should be able to feel confident taking acetaminophen during your pregnancy to control the debilitating symptoms of gout.
Avoiding NSAIDs
Pregnant women should avoid NSAIDs because of the risk of fetal complications, miscarriage, and birth complications. Additionally, NSAIDs can cause renal issues in both the mother and baby as well as low levels of amniotic fluid. There are other medications that are effective in controlling pain and inflammation without the negative effects that NSAIDs have.
Colchicine
There is limited research about the use of colchicine to treat pregnant women who have gout. Although it reduces inflammation, this type of pharmaceutical therapy requires close medical monitoring to avoid risks to the growing fetus.
Joint Aspiration
Also known as arthrocentesis, joint aspiration is a medical procedure that can help relieve the symptoms of gout. During this procedure, the fluid from the inflamed joints is aspirated with a needle to help the patient have more relief from the pressure felt in the joints. The procedure is also used for diagnostic analysis to help doctors confirm if there is an excess amount of uric acid crystals in the joints.
Monitoring Uric Acid Levels
Since gout attacks occur when uric acid levels are high, it is key to have constant monitoring. Along with consistent monitoring of uric acid levels, the healthcare provider must also assess other physiological changes.
Hydration
In general, pregnant women must stay hydrated, but this is especially important if they have gout. Enough hydration with fresh purified water helps to flush out excess uric acid in the body, providing symptom relief and overall improvement of the condition.
Frequently Asked Questions
How do you get rid of gout when pregnant?
Pregnant women who have gout should make dietary changes that focus on staying hydrated and eating low-purine foods. Medical monitoring is also important to keep gout under control.
Why am I suddenly getting gout?
The onset of gout can be caused for many reasons including elevated uric acid levels, pre-existing conditions, genetics, and even certain medications.
What causes gout in feet in females?
Gout is caused by the accumulation of uric acid crystals in the joints. Hormonal changes, obesity, dietary factors, dehydration, and other factors cause gout.
What are the biggest causes of gout?
The major cause of gout is elevated levels of uric acid from consuming purine-rich foods and dehydration.
What stops gout immediately?
Gout is immediately relieved by flushing out the system of uric acid and controlling inflammation.
Can hot water reduce gout?
Warm water soaks can improve blood flood, reduce inflammation, relax muscles, and relieve pain.
What fruit is good for gout?
Low-purine fruits include berries, cherries, bananas, apples, pineapple, watermelon, and citrus.
Which food can reduce uric acid?
Low-purine fruits and vegetables, whole grains, and low-fat dairy products help manage uric acid levels.
What are the 4 stages of gout?
The 4 stages of gout include:
- 1. Asymptomatic
- 2. Acute
- 3. Intercritical
- 4. Chronic Tophaceous
Is gout bad for pregnancy?
Yes, gout during pregnancy can create risks and complications. Pregnancy outcomes can vary and are greatly supported by close medical monitoring.
Does milk reduce gout?
Low-fat dairy products help reduce uric acid levels. Some research suggests that foods high in calcium can prevent gout.
What deficiency causes gout?
Hydration is the only deficiency that may cause gout. The condition is mainly caused by excessive levels of uric acid, which is exacerbated when dehydrated.
Should I walk with gout?
If you are able to walk comfortably during a gout flare-up, you can walk moderately. However, rest alleviates gout symptoms and provides regeneration of the joints.
Can stress cause gout?
Stress does not directly cause gout, but it can create unfavorable lifestyle choices that contribute to gout. It also impacts immune function and bad sleeping habits that can cause gout attacks.
Is gout very serious?
Gout can become serious when it is not well-managed. The disease can lead to other conditions such as obesity and depression, which can greatly decrease your quality of life.
What medication is used to prevent gout?
Several medications help prevent and manage gout such as allopurinol, febuxostat, lesinurad, colchicine, and others.
What foods irritate gout?
Purine-rich foods irritate gout and should be avoided. These foods include tuna, mushrooms, organ meats, shrimp, turkey, yeast, legumes, and other items.
Treating gout while pregnant
Pregnant women who have gout must be closely monitored by a healthcare professional. Uric acid levels have to be regularly assessed. Making nutritional changes is a key factor for treating gout.
