Multiple sclerosis and pregnancy. Features of the course of pregnancy, childbirth and the postpartum period in women suffering from multiple sclerosis. Results of observations of patients in this group in the Moscow region. Childbirth with multiple sclerosis: general characteristics

Currently, multiple sclerosis is not a contraindication to pregnancy. A woman suffering from this disease has every chance of bearing and giving birth to a healthy child. A caesarean section is not necessary - childbirth can occur naturally. There are no contraindications for spinal anesthesia during childbirth.

During pregnancy, you should not take medications that affect the course of multiple sclerosis. Because of them, the fetus may experience birth defects. Fortunately, the risk of exacerbation of the disease in pregnant women is very low.

There is no need to be afraid. There is no need to listen to common “horror stories”. If you suffer from multiple sclerosis and decide to get pregnant, come for a consultation with a doctor at the Yusupov Hospital. You will receive detailed, competent recommendations and answers to all your questions.

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Just 20 years ago, doctors did not know how exactly the body of a woman with multiple sclerosis would react to pregnancy. However, it has now been established that this disease does not affect reproductive function or a woman’s ability to bear and give birth to a healthy child. The risk of intrauterine growth retardation increases slightly. But, for example, the risks of developing serious pregnancy complications such as preeclampsia or arterial hypertension are the same as in healthy women.

Previously, it was believed that pregnancy sharply aggravates the course of multiple sclerosis. But now researchers have found that this is not at all the case. However, in antenatal clinics, patients with multiple sclerosis can still hear: “Have an abortion, otherwise there will be a serious complication and you will not get up after childbirth.” In fact, during pregnancy and childbirth, women with multiple sclerosis, as a rule, feel very well.

What does a woman with multiple sclerosis who is planning a pregnancy really need to know?

Firstly, because of this disease there are no restrictions on the number of pregnancies and the age of the expectant mother. Restrictions can only be related to some other circumstances.

Secondly, during pregnancy you should not take medications that are usually used for multiple sclerosis. Therefore, approximately two weeks before planning a pregnancy, you need to stop taking these medications and then not resume taking them. However, most women become pregnant while taking medications and find out about their situation already in the 3-4th week of pregnancy. Then you need to abruptly stop treatment, since these drugs are believed to have a teratogenic effect (affect the fetus). However, having an abortion in such a situation is not recommended.

The course of pregnancy and childbirth

During pregnancy, a woman should not take the medications she usually takes to control multiple sclerosis. Fortunately, the risk of exacerbations during pregnancy is reduced.

Unfortunately, obstetricians and gynecologists are often afraid to perform natural childbirth in women with multiple sclerosis. But childbirth is an autonomous process; damage to the myelin sheath cannot affect it in any way; the uterus itself contracts under the influence of certain hormones. Therefore, it is impossible to perform a caesarean section without indications, just because the patient has multiple sclerosis. As for epidural anesthesia, the available data indicate its safety, and doctors in civilized countries leave the right of choice to the patient.

Lactation

If during pregnancy the risk of exacerbations of multiple sclerosis decreases, then after childbirth it returns to its previous level or even increases slightly. The fact is that a woman has a stressful situation: she can’t get enough sleep, she has a lot of worries and worries. And this is one of the incentives for the development of exacerbation. But it is impossible to prescribe medications immediately after childbirth, since the woman must breastfeed the baby for some time, and this is a contraindication for taking medications.

Bibliography

• ICD-10 (International Classification of Diseases)
• Yusupov Hospital
• Gusev E.I., Demina T.L. Multiple sclerosis // Consilium Medicum: 2000. - No. 2.
• Jeremy Taylor. Health according to Darwin: Why we get sick and how it is related to evolution = Jeremy Taylor “Body by Darwin: How Evolution Shapes Our Health and Transforms Medicine.” - M.: Alpina Publisher, 2016. - 333 p.
• A.N. Boyko, O.O. Favorova // Molecular. biology. 1995. - T.29, No. 4. -P.727-749.

Multiple sclerosis (MS) is most often diagnosed in women of childbearing age (between 20 and 30 years old), who often turn to their doctor with the question of how this disease affects the course of MS and the fetus during pregnancy. In addition, most patients express concerns that a possible increase in neurological deficit after childbirth will not allow them to fully fulfill their immediate responsibilities in raising and providing for the child, who, in turn, may be born potentially sick, incl. MS (which negatively affects pregnancy planning). Accordingly, attending physicians are often faced with the question of the possibility of pregnancy and the choice of tactics for managing pregnancy and childbirth in patients with MS.

INFLUENCE OF PREGNANCY ON THE COURSE OF MS

At the moment, we can confidently state a more favorable course of MS and a reduced risk of exacerbation of the demyelinating process during pregnancy: during pregnancy, there is a gradual decrease in disease activity by the third trimester (with a maximum restoration of the frequency of exacerbations by the 3rd month after birth). This feature of the course of MS during pregnancy is explained by the processes of immunosuppression, the mechanism of which is currently being actively studied.

The mechanism of immunosuppression (during pregnancy) is due to specific immune reactions occurring in a woman’s body during pregnancy. During this period, the content of certain hormonal fractions in a woman’s blood increases, such as estriol, 17-β-estradiol, progesterone, prolactin, testosterone. Estrogens and progesterone inhibit nitric oxide and inhibit the production of certain proinflammatory cytokines (tumor necrosis factor α) by microglial cells, which ultimately leads to inhibition of immune processes. Immunosuppression is also facilitated by the increased production during pregnancy of calcitriol (an active metabolite of vitamin D3), a protein that inhibits lymphocyte production and the proliferation of proinflammatory cytokines. These changes in the hormonal background of a pregnant woman lead to a decrease in the activity of autoimmune reactions (immune autoaggression is a leading factor in the pathogenesis of MS). In addition, the fetus itself also takes part in the mechanisms of immunosuppression during pregnancy, which secretes cytokines that reduce the production of pro-inflammatory cytokines by the maternal body and shift the balance of T-helpers and T-suppressors towards the latter (you can learn about the immunopathology of MS in the article “Immunopathogenesis of multiple sclerosis ").

But it should be noted that if the clinical picture of MS does not change significantly during pregnancy, then in the early postpartum period it worsens significantly (the risk of developing a relapse of the disease in the postpartum period increases sharply): the presence of exacerbations of MS in the first 3 - 6 months is unanimously noted by all authors: exacerbations observed in 30 - 70% of women, with 80 - 85% occurring in the first 3 months). In a postpartum woman, the pyramidal and cerebellar structures are affected, which is manifested by tetraparesis, paraplegia or hemiplegia of varying severity, intentional tremor, and significant discoordination disorders. Patients are also affected by all types of sensitivity, psyche, and function of the pelvic organs. Exacerbations of MS (exacerbation) that occur in the first months after childbirth can be triggered not only by hormonal changes, but also by the stressful influence of childbirth itself, a significant increase in physical activity associated with caring for a child (excessive fatigue, lack of sleep, breastfeeding, etc. .).

INFLUENCE OF MS ON THE FETUS, PREGNANCY AND CHILDREN

As mentioned above, women suffering from MS very often turn to their doctor with the question of how this disease affects the fetus during pregnancy. Taking into account the results of long-term studies, it can be reliably stated that there are no differences in children born to patients with MS and healthy women in terms of total weight and gestational age (the presence of MS in the mother does not affect the incidence of preterm birth, mortality or pathology of newborns). It has also been shown that the risk of spontaneous abortion in women with MS and the risk of complications during the childbirth period are the same in both MS patients and healthy women. There are no contraindications to spontaneous childbirth naturally in patients with MS: according to numerous observations, childbirth in patients occurs without serious complications. Other methods of delivery are prescribed by obstetricians-gynecologists for medical reasons. During obstetrics, all types of anesthesia can be used: general, epidural, local infiltration (these issues must be resolved by the anesthesiologist and obstetrician on an individual basis). Thus, the tactics of managing pregnancy, childbirth and the postpartum period in pregnant women with MS are practically no different from healthy women.

Regarding the risk of having a child potentially affected by multiple sclerosis, current data indicate that MS is not a genetic disease that is inherited, but there is a genetic predisposition to its development: if for the population as a whole the risk of developing the disease is 0, 2%, then in families of MS patients the risk of developing the disease increases to 20%.

BREASTFEEDING AND MS

Childbirth, of course, is a great stress for the woman and for the child. Therefore, early attachment of the child to the mother’s breast is necessary for both the woman herself and the child, since it is at this time that an inextricable psychological connection arises between them, and the woman quickly gets rid of all the anxieties and experiences associated with childbirth. However, it must be taken into account that long-term breastfeeding does not prevent the restoration of the frequency of exacerbations by the end of the 3rd month after birth. Accordingly, women with MS should be advised to initiate early breastfeeding followed by a short course of breastfeeding with complete cessation by the end of the 1st month after birth and prompt initiation of multiple sclerosis modifying drugs (MSMDs) to reduce the risk of postpartum exacerbations (however, there are recommendations that indicate that breastfeeding is considered optimal for up to 3 months [in rare cases – up to 6 months], then the child should be switched to artificial feeding, and the mother should be re-prescribed IMT).

According to the FDA (Food and Drug Administration), all drugs used during lactation are divided according to the degree of safety into various categories: from L1 (the drug is safe) to L5 (the drug is contraindicated). Drugs: glatiramer acetate, interferons and natalizumab are classified as L3 (moderate safety of use). Fingolimod is classified as L4 (high risk), mitoxantrone is classified as L5 (contraindicated). However, no comprehensive studies have been conducted on this problem, so treatment with immunomodulatory drugs should be discontinued during breastfeeding.

USE OF PETERS DRUGS DURING PREGNANCY

The possibility of using DPT drugs during pregnancy with MS remains an unresolved problem (although there is evidence of the absence of a teratogenic effect in glatiramer acetate [Copaxone]), so the issue of their withdrawal is currently being decided unambiguously: if pregnancy is confirmed, DT drug use should be discontinued. Treatment can be resumed only after pregnancy or breastfeeding (you can learn about the principles of treating MS in the article “Principles of treating multiple sclerosis”).

Taking into account the data obtained during clinical studies at the pre-registration and post-marketing stages, the FDA in the USA prescribed recommendations for doctors on the tactics of managing MS patients in women of childbearing age in order to reduce the risk of teratogenic effects, which indicated a desirable 3-month interval between a break in the course of DMTs and pregnancy. According to the National MS Society recommendations (USA), a woman should stop treatment with interferons and glatiramer acetate one full menstrual cycle before trying to conceive a child. Therapy with fingolimod and natalizumab should be discontinued within 2 months. before the expected pregnancy. It is necessary to take into account the aftereffect of cytostatics: if the patient received mitoxantrone, cyclophosphamide or methotrexate, then pregnancy is undesirable for six months after their discontinuation.

However, at present, other tactics for managing this category of patients are increasingly being used. It is recommended to cancel DMTs not 3 months before the onset of pregnancy, but immediately upon registration of pregnancy. This tactic allows you to control the disease before pregnancy, after registration of which the natural mechanisms of immunosuppression in the body of a pregnant woman begin to be launched. When using this approach, DMT drugs do not have any teratogenic effect on the fetus (Sandberg-Wollheim M. et al., 2011).

All women of childbearing age suffering from MS should be warned about the need to use contraception during treatment and discontinue immunomodulatory and immunosuppressive therapy when planning pregnancy. If pregnancy does occur, treatment should be stopped before the baby is born and resumed immediately after delivery or after breastfeeding has ended. The use of DPTRS in the early stages of pregnancy cannot be an indication for abortion, but immediate discontinuation of the drug is necessary when pregnancy is confirmed.

THERAPY FOR MS EXCERNSATIONS DURING PREGNANCY AND THE POSTPARTUM PERIOD

If an exacerbation occurs during pregnancy, it is possible to prescribe short intravenous courses of corticosteroids (drug therapy during pregnancy is carried out taking into account the balance of the benefits of a particular drug and the risk of its adverse effects on the fetus). Preference is given to the drug methylprednisolone, because it, unlike dexamethasone, is metabolized in the body before passing the placental barrier. Its use is safe from the second trimester (the drug can be prescribed in exceptional cases - for health reasons - and in the first trimester of pregnancy). Preference should be given to pulse therapy, which is not accompanied by the development of congenital malformations in the fetus, either experimentally or in small prospective studies.

To verify an exacerbation, it is possible to conduct an MRI of the brain and spinal cord without contrast enhancement, starting from the second trimester of pregnancy. The administration of a contrast agent is not indicated throughout pregnancy (you can read more about the use of MRI during pregnancy in the article “MRI during pregnancy - is it safe?”).

There are descriptions of individual cases of the use of hormonal therapy and plasmapheresis to relieve severe exacerbations in early pregnancy with the subsequent birth of healthy children. However, such patients, after the exacerbation has stopped, must be sent for a medical-genetic and gynecological examination to decide on the possibility of prolonging pregnancy. During lactation, if it is necessary to relieve exacerbations, the administration of methylprednisolone is also not contraindicated (if lactation is necessarily suppressed). The use of immunoglobulin therapy during pregnancy is considered safe.

CONCLUSION

The decision about the possibility of pregnancy with multiple sclerosis remains with the woman suffering from this pathology (after informing the woman by the doctor about all medical aspects of the problem “MS and pregnancy”). MS is not a genetic disease that runs in families, but there is a genetic predisposition to developing it. MS and treatment with DMT drugs are not contraindications for pregnancy and childbirth. Long-term previous therapy with immunomodulatory drugs significantly reduces the risk of exacerbations in the postpartum period. Management of pregnancy and childbirth in patients with MS does not differ from those in the general population. There are no contraindications to spontaneous physiological childbirth in patients with MS (the method of delivery is recommended to be chosen based on obstetric indications used in healthy women). During childbirth, all types of anesthesia (general, epidural, local infiltration) can be used. The choice of anesthesia method is determined by the same factors as in healthy women. Drug therapy during pregnancy is carried out taking into account the balance between the benefits of a particular drug and the risk of its adverse effects on the fetus. During pregnancy and breastfeeding, DMT therapy should be suspended. In case of exacerbation, a short course of pulse therapy with methylprednisolone is possible. The risk of complications and pathology in newborns during previous therapy with immunomodulators does not exceed that in the general population. Breastfeeding can be recommended for up to 1 - 3 months, then the child should be transferred to artificial feeding, and mothers should be prescribed DMTs to prevent exacerbations.

© Laesus De Liro

It occurs more often in women who are of childbearing age than in anyone else. Pregnancy does not cause multiple sclerosis, but because the disease affects women between 20 and 50 years of age, some may become ill during pregnancy.

Symptoms and signs of multiple sclerosis during pregnancy

Symptoms of this disorder can be mild (numbness of the lungs, muscle weakness) and quite severe (paralysis, tremors and loss of vision). Although the disease is not fatal, it is chronic, meaning people with it are not able to recover for the rest of their lives.

Symptoms may come and go for months or more. If symptoms are mild, multiple sclerosis can be difficult to diagnose, especially during pregnancy. Some symptoms of the disease - numbness, bowel and bladder problems, fatigue and frequent mood swings, inability to concentrate and forgetfulness - are very similar to conditions associated with pregnancy.

Treatment of multiple sclerosis during pregnancy

Scientists have developed several drugs that help change the normal course of the disease. These medications are more beneficial if taken in the early stages of the disease. If you experience symptoms of the disease, contact your doctor.

How does multiple sclerosis affect pregnancy?

For women who become pregnant while living with multiple sclerosis or become ill during pregnancy, there is good news: studies have shown that the disease does not harm the baby. In fact, pregnancy may even help some sick women. It has been observed that during pregnancy, some patients experience attacks less frequently than usual. A woman suffering from this disease requires special attention during childbirth. After she gives birth, exacerbations may occur more often, 3-6 months after birth. However, long-term studies have shown that patients with multiple sclerosis who have given birth suffer less from this pathology than those who have not given birth.

Human health is made up of many components, and the state of the nervous system plays a significant role in overall well-being.

After all, it is with its help that impulses are quickly transmitted to destination points, mood changes are controlled, and signals are also transmitted to the brain.

And therefore, any disturbances in the functioning of the nervous system should be carefully monitored in order to begin treatment in a timely manner, as well as to prevent possible serious consequences for the entire body.

Basic concepts about multiple sclerosis

An autoimmune disease of the nervous system, multiple sclerosis has a chronic course.

The main characteristics of the disease can be given as follows.

In a normal state, the human immune system controls the effects of extraneous negative factors on the body’s tissues and actively fights them.

When a malfunction of the immune system occurs, the opposite reaction occurs: the immune system begins to react aggressively, and the aggression is directed towards its own tissues in the body.

This disease most often affects young women, whose age category is from 18 to 25 years. What are the main symptoms of this terrible disease?

An important psychological aspect

When conducting a health examination of a woman with multiple sclerosis and who wants to have a baby, you should be aware that many specialists of the older generation, as well as those who do not have sufficient information about modern methods of preserving and managing pregnancy with multiple sclerosis, may voice their recommendations in an incorrect, unrestrained form.

Today, a proven important fact is the information that bearing and giving birth to a healthy child will be in question only if the stage of the disease is already serious and the pregnancy can cause serious damage to the health of the pregnant woman. Or the woman’s condition is such that even movement is difficult for her.

It is also important to remember that the inheritance of multiple sclerosis is extremely low and does not exceed 2-6%. And this allows us to speak with confidence about the possibility of giving birth to an absolutely healthy baby if the father or mother is sick with this disease. In addition, medical abortion harms a woman’s health even more significantly than the risks of possible complications during pregnancy and childbirth with multiple sclerosis.

And the negative attitude of others towards a woman with multiple sclerosis who wants to have a baby can put significant pressure on the psyche and worsen the course of pregnancy.

For these reasons, one should be very critical of the possible negativity both from ignorant doctors and from the environment.

Physiological aspect

The course of pregnancy and childbirth in a woman with the disease in question does not differ in many respects from the pregnancy of a completely healthy woman.

In both cases there will be certain risks.

However, a larger number of them is not observed in the case of complications with multiple sclerosis, so there is no reason for unnecessary worry.

With multiple sclerosis, a pregnant woman should be constantly under the supervision of doctors, and at the slightest deterioration of her condition, contact a medical facility. At the same time, the number of pregnancies for such a woman is not limited, and the possibility of complications, missed pregnancies and spontaneous miscarriages is approximately the same as for a healthy pregnant woman.

Considering the course of pregnancy with multiple sclerosis, the following pattern of a woman’s condition should be noted:

• During the first third of pregnancy, the risk of complications of any nature is up to 55%. Most often, exacerbations occur if a woman suffered from frequent exacerbations of the disease before pregnancy.
• At the end of the first third of pregnancy, the overwhelming majority of pregnant women report excellent health and an unprecedented increase in vitality - this is a completely normal state, since thanks to the miraculous processes occurring in the body of a pregnant woman, there is maximum consistency of all physiological processes.
• The subsequent risky period begins, according to medical research, immediately before childbirth, when the body produces a significant amount of hormones responsible for preparing the body for the upcoming birth. Hormonal changes in the body occur, which can provoke an exacerbation of the disease.

The condition during pregnancy in women with multiple sclerosis should not cause serious concern; the main condition is constant monitoring of health.

In addition, the doctor will prescribe a treatment regimen for the underlying disease during pregnancy, because during this period, some of the medications prescribed to stabilize the condition in multiple sclerosis are discontinued.

Video on the topic

The disease is characterized by inflammation in the brain and spinal cord. Multiple sclerosis in a woman or a man (her husband) can occur in different forms: in the initial stage and progressive.

The course of the initial stage is characterized by the following symptoms:

In addition, a woman may experience symptoms such as:

• tremor;
• paralysis;
• visual impairment.

Pathogenesis

In multiple sclerosis, it is not the neurons themselves that die, but the myelin sheath of the axons—the long processes of neurons through which they transmit information—that are destroyed.

The myelin sheath is a kind of electrical insulation, preventing the nerve signal, which is an ordinary electrical impulse, from going out after being absorbed by the body, being knocked down by any external influence, or going the wrong way.

When the shell is destroyed, the neuron can no longer perform its functions and becomes completely useless, as if dead.

At the site of damage to the membrane, special connective tissue plaques form, sometimes reaching gigantic sizes. Compared to the cell itself, with which the body tries to restore the loss.

What a woman needs to know

It is worth knowing that they do not have any really important reasons for such behavior, nor do they have a moral right. Attempts to terminate a pregnancy are nothing more than ordinary reinsurance in order to reduce the number of probable negative outcomes in one’s area, as well as to get rid of unnecessary responsibility and the hassle of enhanced monitoring.

During pregnancy, multiple sclerosis usually does not appear. In addition, the disease is not a direct indication for a cesarean section.

Childbirth is a completely autonomous process that is not affected by damage to the myelin sheath. The uterus contracts under the influence of hormones.

Epidural anesthesia, according to many doctors from Western countries, is completely safe, but the right of choice still remains with the patient.

With a complicated pregnancy and exacerbation of multiple sclerosis, a woman may not feel the onset of contractions. Therefore, the expectant mother must remain in the hospital for the last few months.

Doctors may need to artificially induce labor. At the same time, a woman with such a diagnosis needs to give birth faster, because the disease greatly tires the body, and fatigue sets in much faster than in healthy patients.

Planning a pregnancy

If one or both spouses have multiple sclerosis, pregnancy planning should be approached with caution.

It was already mentioned above that the disease is inherited, both on the maternal and paternal lines, but the risk of this method of infection is minimal.

If one of the parents is sick, then the probability of transmitting multiple sclerosis by inheritance is 5%; if both parents are diagnosed, it is 10-15%.

We should not exclude the possibility that the disease will appear in a child only by the age of 20-30.

In addition, if the disease is not transmitted to the child, then parents should be concerned about the following questions: will they be able to properly care for their baby, will the diagnosis of multiple sclerosis affect his health after birth.

In addition, it has been scientifically proven that the exacerbation of the disease in a woman increases after the birth of a child, when during pregnancy it can, on the contrary, decrease.

However, 5-10% of women may experience relapses of the disease in the early stages of pregnancy. But, as a rule, they pass quickly.

Many doctors say that pregnancy allows you to get rid of this disease, but only for a while. The exacerbation of the disease after the birth of a child is well explained: the woman simply experiences new emotions, worries about her child.

As a rule, most often pregnancy with multiple sclerosis proceeds well and the child is born healthy, and therefore abortion should be excluded.

Fact! The risk of developing MS increases in young nulliparous women. There is a low probability of having this disease in girls who have given birth to 2 or more children.

If multiple sclerosis was diagnosed before pregnancy, then the woman is already undergoing treatment. If you are planning a pregnancy, be sure to consult a doctor first.

Since many drugs taken for MS are not compatible with pregnancy. In addition, other medical procedures and dietary nutrition can negatively affect the development of the fetus.

Any medicine prescribed to treat multiple sclerosis should be discussed with your doctor. Be sure to find out how it can affect your child's development.

Considering that the majority of patients are women of reproductive age, it is absolutely natural that many patients become pregnant or, conversely, many pregnant women receive such a diagnosis.

But few people know how multiple sclerosis and pregnancy affect each other.

In the last century, multiple sclerosis during pregnancy was an indicator for compulsory medical abortion, however, with a more thorough study of the disease and the discovery of methods for its relative treatment, the position of doctors has changed dramatically.

Exacerbations of the disease during pregnancy occur extremely rarely, as do cases of detection of this disease. Almost always the woman gets sick before her. We can say that during pregnancy sclerosis takes a kind of break, except in rare cases.

Exacerbations of the disease during pregnancy are extremely rare, but still sometimes occur. Approximately 65% ​​of them occur in the first trimester of pregnancy, and they occur more often only in those who had them often before pregnancy.

In this case, exacerbations are much milder, and the patient recovers very quickly.

After the first trimester, many patients report an unprecedented sense of well-being, which generally persists until the end of the term, also for about three months after childbirth.

During pregnancy, it is prohibited to take certain medications designed to fight the disease, however, due to natural processes that restrain the mother’s immunity on its own, this is almost not required.

Now doctors do not prohibit sick women from having a child, since it has been proven that this has a beneficial effect on the mother herself and is also safe for the baby, although such expectant mothers are monitored much more carefully.

There is evidence that pregnancy with multiple sclerosis can lead to improvement in women's condition. In general, the pathology has a more stable and benign course during pregnancy.

In the first year after the baby is born, the number of exacerbations may increase. This is due to increased physical and neuropsychic stress on the female body.

Moreover, the incidence rate in women who have given birth to two or more children is 2.5 times less than in those who have not given birth. In addition, conceiving a child leads to a decrease in the incidence of disability and increases life expectancy.

Thus, pregnancy is considered to be an immunosuppressive factor for the disease. This is manifested both in the analysis of clinical symptoms and in instrumental studies.

If an exacerbation is observed at the beginning of pregnancy, it has a mild and short course.

After childbirth, the pathological process may intensify. Exacerbations are much more difficult, and neurological symptoms become more pronounced. Therefore, it is very important to avoid unplanned pregnancies that end in abortion.

In this situation, a strong hormonal imbalance occurs in the woman’s body, which causes the progression of the disease. In the absence of pronounced clinical symptoms in such a situation, the question is raised regarding the continuation of pregnancy.

The use of hormonal drugs also worsens the condition of sick women. If the patient is planning to conceive a child, immunomodulators should not be used three months before the expected pregnancy.

Sirdalud, baclofen, finlepsin are also contraindicated. All these drugs have a teratogenic effect. The use of such medications is resumed after childbirth and completion of breastfeeding.

According to experimental data, Copaxone has no effect on the intrauterine development of the baby. The use of this drug during pregnancy and lactation is currently the subject of debate.

The social aspect of the issue is no less important, because often families where one of the spouses has such a disease breaks up. If the child is desired, then the issue of possible pregnancy should be discussed with a neurologist.

In such a situation, it is very important that the woman is observed by qualified specialists during the period of bearing a child.

During pregnancy, it is strictly forbidden to take medications that the woman usually took. The good news is that the risk of exacerbations during pregnancy is naturally reduced.

Scientists from the University of Calgary have proven that the pregnancy hormone prolactin helps in the treatment of women with multiple sclerosis.

In addition, the disease is characterized by the fact that the immune system begins to destroy myelin, and during the period of bearing a child, the woman’s body stops doing this.

Exacerbations cannot be stopped with medications so as not to harm the child’s health. Thirty percent of women experience an exacerbation of the disease immediately after childbirth, and the vast majority - two or three months after the birth of the baby.

In the first trimester, the risk of exacerbation of multiple sclerosis during pregnancy (feedback from women confirms this) is high - up to 65%.

This is why it is so important to undergo a medical examination as early as possible. The condition of those expectant mothers who have experienced frequent exacerbations of MS even before conception worsens more often.

Fortunately, pregnant women tolerate exacerbations more easily, and their bodies recover faster.

What are the consequences of pregnancy with multiple sclerosis? Many experts agree that in the case of a cesarean section, the negative consequences for the mother are minimized.

Even in the absence of symptoms, it is necessary to undergo a medical examination, and, as a preventive measure, undergo therapy with immunomodulatory drugs.

Pregnancy with multiple sclerosis (life expectancy for this disease is approximately 35 years after diagnosis) can help establish long-term remission.

Before pregnancy, a couple should definitely consult a competent specialist. The husband may have to stop taking medications for a while.

Otherwise there are no risks. The disease is inherited only in three to five percent of cases if one of the parents suffers from multiple sclerosis, in ten percent of cases - if both are diagnosed.

During pregnancy, a woman should not take the medications she usually takes to control multiple sclerosis. Fortunately, the risk of exacerbations during pregnancy is reduced.

MS Treatment Methods

At the moment, there are no drugs that can completely cure multiple sclerosis. But the disease is progressive.

Periods of exacerbation constantly alternate with periods of remission. Only adequate treatment can significantly prolong remission.

Therapy is aimed at reducing inflammation and relieving symptoms.