Abstract
Rheumatoid arthritis (RA) is extremely uncommon during pregnancy. The alterations in the immune system that occur to support the developing fetus make the onset of RA during this period unlikely. In this case report, we describe a 26-year-old pregnant woman who presented with bilateral symmetrical pain in her hands, wrists, and ankles at 24 weeks of gestation. After a thorough evaluation, she was diagnosed with active RA based on clinical symptoms and laboratory findings, including elevated inflammatory markers, positive RA factor, and anti-cyclic citrullinated peptide antibodies. Treatment was initiated with hydroxychloroquine (HCQ), prednisolone, and paracetamol, resulting in significant symptom improvement and no postpartum complications. The patient gave birth to a healthy baby via vaginal delivery, highlighting the management challenges and outcomes linked to RA during pregnancy.