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Multiple sclerosis: management issues during pregnancy.

Simone Ferrero1, Stefano Pretta, Nicola Ragni

  • 1Department of Obstetrics and Gynaecology, Ospedale San Martino, University of Genoa, Genoa, Italy. simone.ferrero@fastwebnet.it

European Journal of Obstetrics, Gynecology, and Reproductive Biology
|June 30, 2004
PubMed
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Pregnancy generally stabilizes multiple sclerosis (MS) symptoms, with relapses increasing postpartum. Most MS medications are safe for pregnant women, but some require discontinuation before conception.

Area of Science:

  • Neurology
  • Obstetrics
  • Reproductive Health

Background:

  • Multiple sclerosis (MS) care during pregnancy presents unique challenges due to physiological changes and fetal considerations.
  • Pregnancy often leads to MS clinical stability or improvement, followed by a significant relapse rate in the early postpartum period.

Purpose of the Study:

  • To review the safety and management of multiple sclerosis during pregnancy.
  • To provide guidance on medication use, delivery, and anesthesia for pregnant women with MS.
  • To reassure women with MS about pregnancy and infant outcomes.

Main Methods:

  • Literature review and synthesis of existing data on multiple sclerosis and pregnancy.
  • Analysis of medication safety profiles, including disease-modifying therapies.

Related Experiment Videos

  • Examination of pregnancy outcomes, delivery complications, and anesthesia options.

    • Main Results:

    • Pregnancy typically does not negatively impact long-term MS disability or infant health.
    • Most MS medications, including intravenous steroids and azathioprine, can be used with relative safety.
    • Methotrexate and cyclophosphamide require caution or avoidance; others like glatiramer acetate and interferons should be stopped before pregnancy.
    • Delivery complications and anesthesia are generally safe for women with MS.

    Conclusions:

    • Women with multiple sclerosis can generally have safe pregnancies and healthy infants.
    • Careful consideration of medication use and timing is crucial.
    • MS management during pregnancy requires a multidisciplinary approach involving neurologists and obstetricians.