Here’s what to do if you’re diagnosed with Fibromyalgia during pregnancy

For those caught unaware, Fibromyalgia is a rare and chronic syndrome, which has symptoms similar to those of pregnancy. 

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During pregnancy, it is quite common for the expecting mother to experience nausea, overall body weakness, muscle pain and mood swings, mostly during the first and third trimesters. However, do you know all these symptoms are also indicators of Fibromyalgia? A condition that even American singer-songwriter Lady Gaga suffered from, as revealed by her in 2017

What is Fibromyalgia?

It is a chronic syndrome, which is characterized by widespread pain, sleep and emotional disturbances, and fatigue. This rare condition affect 6 to 15 percent of the population in the US. It affects the nervous system, immune system and hormones. The multiple signs and symptoms of Fibromyalgia usually develops around reproductive age, with females being more susceptible to develop it than males.

If you are diagnosed with Fibromyalgia during your pregnancy, it is necessary to understand the causes, symptoms and complications of this condition. It is so because the chances to misdiagnose Fibromyalgia because most of its symptoms are same as those of pregnancy.

Causes of Fibromyalgia

While the exact cause of Fibromyalgia is unknown, but there are some theories, based on levels of different hormones, stress levels, biomechanical changes, weight gain, genetic predisposition, and alterations in autonomic systems and immune system.

During pregnancy, the placenta releases various chemicals like cytokines, neuropeptides, neuro-steroids, and amines. So, these neuro-hormones may be responsible for developing or triggering Fibromyalgia symptoms. Moreover, the hormones released by ovaries are linked with alterations of pain perception and loosening of joints and ligaments in the whole body.

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Neuroendocrine transmitters such as serotonin, cortisol, growth hormone and substance P control the working of autonomic and neuro endocrine systems, which are considered as roots of developing fibromyalgia.

During pregnancy, when there are changes in pain perception and sensory perception due to low levels of serotonin hormone, it can lead to development of Fibromyalgia.

Symptoms of Fibromyalgia

There are chances that its symptoms may be aggravated during the first and third trimester of pregnancy. But in some women it has been seen that the symptoms may get relieved too. Look for these signs:

1. Widespread pain, in lower back, chest, abdomen and legs
2. Tiredness and low energy levels
3. Nausea, headaches and dizziness
4. Altered sleep patterns
5. Anxiety and depression
6. Memory related challenges
7. Restrictions in daily activities
8. Irritable bowel syndrome, like constipation, challenges with urination, and hemorrhoids
9. Leg swelling and varicose veins
10. Heartburn and nose bleeding
11. Breathing difficulties
12. Fear of childbirth

How to diagnose it?

There is no definitive test available to diagnose the condition, but your doctor will do a thorough examination, including detailed history, physical assessment and overall emotional and behavioral status. To confirm the condition, a certain criteria needs to be met like:

1. Symptoms persist for more than 3 to 6 months
2. Pain in more than 7 tender points when doctor checks over definitive areas
3. Fear, anxiety, fluctuating moods, and depression
4. Irritable bowel syndrome symptoms

What is the impact of Fibromyalgia on pregnant women and the baby?

As multiple systems are involved in Fibromyalgia, it aggravates the pregnancy-related symptoms mainly in the first and third trimester. Some symptoms, such as anxiety, depression, physical and psychological stress, can have direct and indirect effects on pregnant women and also on babies.

With babies, it can lead to.

1. Intrauterine growth restriction (IUGR), where weight and overall development of baby is hampered.
2. Frequent miscarriage
3. Premature delivery, as some studies show that there are chances of early labor.

In case of pregnant women, it can cause

1. Stress, anxiety, depression and fear of childbirth: These symptoms can be seen in more severe form with Fibromyalgia. This may affect the ability of the woman to deliver naturally and recovery period of post-delivery.
2. Gestational diabetes: It is quite common to have it in Fibromyalgia as the blood sugar levels elevate during pregnancy and as you deliver, they get balanced. If it goes unnoticed, then there are chances that the mother can develop complications like pre-eclampsia, that is high blood pressure, delivering extra-large baby, and even hypoglycemia, which means low blood sugar levels in the baby immediately after birth.
3. Preterm premature rupture of membrane (PPROM): If water breaks before 37^th week of pregnancy, it is considered as preterm or premature rupture. Since there is leakage of water, there are chances of getting infection to the mother.
4. Placental abruption: The separation of placenta from uterus, which causes blood loss, can interupt the supply of nutrients and oxygen to the baby, in case of fibromyalgia. It may cause early delivery, vaginal bleeding, rapid contractions and abnormal heart rate of the baby.
5. Venous thromboembolism: It’s a serious complication as there is blood clot stuck inside the deep veins of the lower body, which restricts blood from the area, which can even be even fatal.
6. Polyhydroamnios: It’s a rare complication when an excessive amount of amniotic fluid is present in the amniotic sac that may lead to preterm delivery, and placental abruption.

<img class=”wp-image-31716 size-full” src=”https://www.healthshots.com/wp-content/uploads/2021/11/gestational-diabetes.jpg” alt=”gestational diabetes during pregnancy,” width=”1600″ height=”900″ /> Keep your sugar in check during pregnancy. Image courtesy: Shutterstock

Treatment measures during pregnancy

As pregnancy is a crucial phase of every woman’s life, this condition is well- managed pharmacologically and conservatively. It is best to have regular follow-ups with your doctor and taking medications with proper dosages are important. Health care professionals like physiotherapists can help you to cope with these symptoms efficiently.

The following are a few guidelines that can be of help:

1. Lifestyle modifications such as dividing your activities, taking breaks in between, and having rest for at least 15 to 20 minutes after every three hours.
2. Taking support from family members and friends.
3. Adapting a healthy and balanced diet.
4. Massage, like kneading over the back, leg and arms can be useful.
5. Yoga including asanas, Pranayama and meditation can help to boost levels of serotonin hormones, which in turn will help to balance mood and overall energy levels.
6. Exercises such low intensity stretches, strength based exercises, and slow paced aerobic exercises can be done to improve flexibility, strength and stamina.

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Dr Karishma More

Dr Karishma More, Executive Physiotherapist, Cloudnine Group of Hospitals, Pune..