Everything to Know About Chorea in Pregnancy

Medically Reviewed By Priya Patel, MD

Chorea gravidarum is a rare group of movement symptoms that can develop during pregnancy. They may result from changes or injury to your brain’s nerve cells. Examples include muscle weakness, involuntary motions like twitching, and speech difficulties. Chorea itself involves irregular, unintentional movements. Typically, chorea gravidarum isn’t an official diagnosis or condition. Instead, doctors may use the phrase “chorea gravidarum” to describe chorea that occurs during pregnancy.

This article discusses chorea gravidarum symptoms, causes, treatment, and outlook.

Symptoms

A pregnant person holds their belly while standing in direct sunlight.
Eloisa Ramos/Stocksy United

Chorea consists of unplanned, noncontinuous motions that usually affect your face, arms, and legs. They may worsen with stress or fatigue and can appear similar to dancing but may happen anytime.

Other symptoms Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source of chorea include:

  • muscle weakness
  • unintentional facial expressions like twitching or grimacing
  • difficulty coordinating movements
  • speech difficulties
  • gait changes
  • involuntary, irregular tongue motions
  • a relapsing grip similar to milking by hand, known as the milkmaid’s sign
  • unexpected, repetitive gestures or sounds

These symptoms can vary in intensity. In chorea gravidarum, they may appear suddenly within the first trimester of pregnancy and typically go away in the third trimester or shortly after childbirth.

If you’re pregnant, contact a doctor about new, persistent, or concerning movement symptoms.

Read more about chorea, including its symptoms, outlook, and answers to frequently asked questions.

Causes

The exact cause of chorea gravidarum is unknown Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source .

However, chorea outside of pregnancy often links to changes in your basal ganglia nerve cells, which help coordinate movement.

For example, chorea may develop during pregnancy due to hormonal changes Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source affecting your basal ganglia cells. These changes may cause an immune response, leading to autoimmune activity that injures your basal ganglia cells.

Other causes Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source of chorea can include:

Sometimes, doctors can’t identify chorea’s cause.

When to see a doctor

Contact a doctor as soon as possible if you notice any of the following symptoms:

  • sudden, unplanned movements
  • persistent muscle weakness
  • difficulty speaking or swallowing
  • unusual changes in motions or behavior

If you experience those symptoms during pregnancy, get immediate medical attention. While chorea may not be serious for every person affected, early diagnosis and treatment can relieve symptoms, reduce the risk of complications, and rule out other conditions.

Diagnosis

To diagnose chorea gravidarum, a doctor can start by asking about your symptoms and medical history.

  • When did you begin experiencing the involuntary motions or symptoms?
  • Have the movements and symptoms been continuous, or do they come and go?
  • Have you noticed whether anything worsens or relieves your symptoms?
  • Do you have a history of rheumatic fever or a streptococcal infection?
  • Have you had previous pregnancies, and if so, did you have similar symptoms?
  • Do you have a family history of autoimmune conditions or movement disorders?

Your medical team can then perform a physical examination to assess your symptoms. They may also order Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source :

  • neurological exams to assess your muscle tone, reflexes, and coordination
  • an echocardiogram to check for heart conditions or rheumatic heart disease
  • blood tests
  • liver function tests
  • thyroid tests
  • imaging studies to rule out other conditions, such as MRI or CT scans

Treatment and management

Chorea gravidarum treatment typically involves approaches to relieve symptoms.

A doctor may prescribe medications if you have severe symptoms or if the fetus is at risk of malnutrition or dehydration.

Medications for chorea outside of pregnancy can include anticonvulsants Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source , antipsychotics, or benzodiazepine Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source medications to reduce unpredictable movements. However, some of these medications may not be safe Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source for some pregnant people. Your medical team can tailor their treatment recommendations to your condition.

Other management approaches for chorea gravidarum include:

  • getting enough rest
  • drinking hydrating fluids
  • participating in physical therapy to help with muscle control and fatigue
  • trying stress management techniques, such as counseling or meditation
  • asking your doctor or medical team about vitamin and mineral supplements
  • having regular checkups with your medical team
  • treating the underlying cause of chorea if you’ve received a diagnosis involving one

Outlook

The outlook for chorea gravidarum can be positive with early diagnosis and management. Symptoms typically go away Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source after childbirth when estrogen levels decrease. Treatment can also help relieve them.

However, chorea gravidarum symptoms can come back Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source if you take estrogen or birth control pills or get pregnant again.

If you have a history of chorea, talk with a doctor for personalized advice during your prenatal visits.

Summary

Chorea gravidarum is a group of rare movement symptoms that can occur during pregnancy. They may include involuntary, irregular motions affecting your face, torso, and limbs.

Researchers are still investigating what causes chorea, but hormonal changes may be the cause when chorea occurs during pregnancy.

Chorea gravidarum often goes away after birth, but medications and self-care can help relieve symptoms.

If you notice new, persistent, or concerning symptoms during pregnancy, talk with a doctor as soon as possible.

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Medical Reviewer: Priya Patel, MD
Last Review Date: 2024 Jun 19
View All Pregnancy Articles
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