Multiple sclerosis

Question 1

How do you counsel a patient with MS about maternal risk and obstetric complications in pregnancy?

Answer 1

The management of multiple sclerosis during pregnancy is supportive.

Pregnancy has no effect on subsequent neurologic disability.

The remission of multiple sclerosis during pregnancy is consistent with observations in other autoimmune diseases and probably relates to a gestational immunosuppressive state

The treatment of acute exacerbations consists of bed rest and prescription of a brief course of steroids, which may hasten recovery without necessarily influencing its extent.

Question 2

What are common symptoms of multiple sclerosis exacerbation?

Answer 2

Balance problems.
Blurred vision or blindness in one eye.
Dizziness.
Numbness.
Pain.
Pins-and-needles feeling.
Tiredness.
Weakness.

Question 3

How does pregnancy affect the risk of multiple sclerosis exacerbation?

Answer 3

There is a tendency for remissions during pregnancy and an increased frequency of multiple sclerosis exacerbations in the first 3 to 6 months after childbirth.

Question 4

How does breastfeeding affect the risk of multiple sclerosis exacerbation?

Answer 4

Breastfeeding does not have an impact on the relapse rate after pregnancy

Question 5

What are common treatment approaches for pregnant women with multiple sclerosis?

Answer 5

The treatment of acute exacerbations consists of bed rest and prescription of a brief course of steroids, which may hasten recovery without necessarily influencing its extent.

Disease-modifying therapies such as β-interferon, glatiramer acetate, or natalizumab are not recommended during pregnancy.

Question 6

How do treatments for multiple sclerosis impact the fetus?

Answer 6

Disease-modifying therapies such as β-interferon, glatiramer acetate, or natalizumab are not recommended during pregnancy because they are known to cause adverse pregnancy outcome such as SAB.