A Successful Pregnancy with Amyotrophic Lateral Sclerosis

Area of Science:

• Neurology
• Obstetrics
• Maternal-Fetal Medicine

Background:

• Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease affecting motor neurons.
• ALS is exceptionally rare in pregnant individuals, posing unique clinical challenges.
• This case involves a 32-year-old woman in her fourth pregnancy with a pre-existing ALS diagnosis.

Observation:

• The patient exhibited complete upper and lower motor neuron and bulbar system involvement.
• Sensory system function remained intact throughout the pregnancy.
• Progressive respiratory compromise and severe mobility limitations were noted.

Findings:

• A multidisciplinary team managed the pregnancy, incorporating obstetric, neurological, and anesthesia specialists.
• The patient received a full course of steroids at 34 weeks gestation.
• An elective cesarean section under general anesthesia was performed due to severe immobility and respiratory distress.

Implications:

• This case highlights the feasibility of managing ALS during pregnancy with a coordinated team approach.
• Successful delivery and good maternal-fetal outcomes are achievable even with advanced ALS.
• Further research into optimal obstetric and anesthetic management for pregnant ALS patients is warranted.