We report here an unusual case of rheumatoid arthritis presenting for the first time in a 32-week pregnant patient. Despite thorough evaluations from different specialties, the patient's diagnosis went undiscovered originally being attributed to orthopedic issues and then to normal symptoms of pregnancy. The patient's symptoms progressively worsened until she was no longer able to ambulate and complete her daily activities. A primary diagnosis of rheumatoid arthritis is exceedingly rare during pregnancy due to changes in the body's immune system that accommodate the foreign fetus. Also physiologic changes that occur during pregnancy can often cloud the clinical picture of a patient presenting with joint pain and weakness. Nonetheless, a thorough workup should be conducted to rule out underlying rheumatologic disease.

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ABSTRACT… Objectives:To determine the frequency of risk factors i.e. consanguinity and maternal age associated with spontaneous abortions in Pakistan and to propose ways to reduce them. Study design: Cross sectional descriptive study. Place of study: Gynecology department of Military Hospital and Combined Military Hospital, Rawalpindi. Duration of study: 6 months (September 2015 to February 2016). Sampling technique: Non probability convenient sampling. Methodology: 150 married female patients in reproductive age group (15-49 years), who were confirmed cases of pregnancy and presented with abortions, were interviewed and responses were filled in a structured questionnaire after written consent. The collected data was then entered and analyzed by SPSS 20.0. Results: The major bulk of spontaneous abortions occurred in the maternal age group of 25-35 years (55.3%). A total of 53.3% of abortions occurred in the gestational age of less than 12 weeks. Around 54.7% of females had family history of spontaneous abortions and 65.3% had consanguineous marriage. Conclusion: Spontaneous abortions occur more frequently in the females of 25-35 years age group and among the fetuses with gestational age less than 12 weeks (1 st trimester of pregnancy). Family history of spontaneous abortions and consanguinity are associated with spontaneous abortions. Key words:Spontaneous abortions, female, reproductive age group, risk factors, consanguineous marriage.