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Chapter 26 - Multiple Sclerosis in Pregnancy

from Section 4 - Neurological Disorders in Pregnancy

Published online by Cambridge University Press:  23 February 2023

By
Alexa Eberle ,
Meena Khandelwal  and
Amira El-Messidi
Edited by
Amira El-Messidi  and
Alan D. Cameron
Amira El-Messidi
Affiliation:
McGill University, Montréal
Alan D. Cameron
Affiliation:
University of Glasgow
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Summary

A 34-year-old G2P1 with long-standing multiple sclerosis (MS) is referred by her neurologist for prenatal care of a spontaneous pregnancy at 10 weeks’ gestation by dating sonography. She takes prenatal vitamins and has no obstetric complaints.

Keywords

Multiple sclerosisMaternal-fetal risksAntepartum, intrapartum, postpartum managementExacerbation, postpartumDisease-modifying drugsInterferon beta/glatiramer acetateNatalizumabCounselingBreastmilk, storage
Type
Chapter
Information
OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
 , pp. 361 - 369
Publisher: Cambridge University Press
Print publication year: 2023

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References

Suggested Readings

Bove, R, Alwan, S, Friedman, JM, et al. Management of multiple sclerosis during pregnancy and the reproductive years: a systematic review. Obstet Gynecol. 2014;124(6):1157–1168.CrossRefGoogle ScholarPubMed
Coyle, PK, Oh, J, Magyari, M, et al. Management strategies for female patients of reproductive potential with multiple sclerosis: an evidence-based review. Mult Scler Relat Disord. 2019; 32:54–63.CrossRefGoogle ScholarPubMed
Dobson, R, Dassan, P, Roberts, M, et al. UK consensus on pregnancy in multiple sclerosis: ‘Association of British Neurologists’ guidelines. Pract Neurol. 2019;19(2):106–114.CrossRefGoogle ScholarPubMed
Fang, X, Patel, C, Gudesblatt, M. Multiple sclerosis: clinical updates in women’s health care primary and preventive care review. Obstet Gynecol. 2020;135(3):757–758.Google Scholar
Kalinowska, A, Kułakowska, A, Adamczyk-Sowa, M, et al. Recommendations for neurological, obstetrical and gynaecological care in women with multiple sclerosis: a statement by a working group convened by the Section of Multiple Sclerosis and Neuroimmunology of the Polish Neurological Society. Neurol Neurochir Pol. 2020;54(2):125–137.Google Scholar
Liguori, NF, Alonso, R, Pinheiro, AA, et al. Consensus recommendations for family planning and pregnancy in multiple sclerosis in Argentina. Mult Scler Relat Disord. 2020; 43:102147.CrossRefGoogle ScholarPubMed
Pozzilli, C, Pugliatti, M, ParadigMS Group. An overview of pregnancy-related issues in patients with multiple sclerosis. Eur J Neurol. 2015;22 Suppl 2:34–39.CrossRefGoogle ScholarPubMed
Thöne, J, Thiel, S, Gold, R, et al. Treatment of multiple sclerosis during pregnancy – safety considerations. Expert Opin Drug Saf. 2017;16(5):523–534.CrossRefGoogle ScholarPubMed
Toscano, M, Thornburg, LL. Neurological diseases in pregnancy. Curr Opin Obstet Gynecol. 2019;31(2):97–109.CrossRefGoogle ScholarPubMed
Varytė, G, Zakarevičienė, J, Ramašauskaitė, D, et al. Pregnancy and multiple sclerosis: an update on the disease modifying treatment strategy and a review of pregnancy’s impact on disease activity. Medicina (Kaunas). 2020;56(2):49. Published 2020 Jan 21.Google Scholar

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