Multiple Sclerosis and pregnancy TOG 2019 Flashcards
What is the incidence of multiple sclerosis
0.1% in UK
More common women, typical age of presentation is childbearing years.
What % of people with MS have an affect family member?
80%
Recurrence risk with 1 affect child with MS?
2.7%
What are the 3 main categories of MS?
- Relapsing remitting MS
- Secondary progressive MS
- Primary progressive MS
What is the most common type of MS? What % of MS?
Relapsing remitting
85%
What scoring system is used to monitor disease progression?
Expanded disability status scale EDSS
0 = Normal
10 = Death cause by MS
Optic neuritis is the 1st symptoms in what %?
20-30%
Is MS more or likely to relapse during pregnancy?
Less likely
Less likely to present for 1st time
What % relapse during pregnancy? When most common?
20-30%
1st 3-4 months
Single best predictor is pre-pregnancy relapse
What symptoms can be worse in pregnancy?
Neurogenic bladder - higher risk UTI
Fatigue
Balance
What % have relapse post-partum? Anyway to reduce this risk?
25% relapse in 3-6 months
Breastfeeding can reduce risk - exclusive for 2 months
Does pregnancy or breastfeeding have any long term effect on course of MS?
No
Association with MS and AMH
AMH reduced in women with MS
MS effects on foetus
No increased risk miscarriage, stillbirth, congenital abnormality.
Maybe slight increase in pretermbirth and low birth weight/FGR 1.7
Which disease modifying drugs can now be continued in pregnancy?
Glatiramer acetate
Interferons
Natalizumab - continue in sebere casea
Risk of stopping - risk rebound within 3 months
