Pregnancy-related issues in women with multiple sclerosis: an evidence-based review with practical recommendations.

Journal of Drug Assessment
Beatriz CanibañoYolande Hanssens

Abstract

Objective: To review the current evidence regarding pregnancy-related issues in multiple sclerosis (MS) and to provide recommendations specific for each of them. Research design and methods: A systematic review was performed based on a comprehensive literature search. Results: MS has no effect on fertility, pregnancy or fetal outcomes, and pregnancies do not affect the long-term disease course and accumulation of disability. There is a potential risk for relapse after use of gonadotropin-releasing hormone agonists during assisted reproduction techniques. At short-term, pregnancy leads to a reduction of relapses during the third trimester, followed by an increased risk of relapses during the first three months postpartum. Pregnancies in MS are not per se high risk pregnancies, and MS does not influence the mode of delivery or anesthesia unless in the presence of significant disability. MRI is not contraindicated during pregnancy; however, gadolinium contrast media should be avoided whenever possible. It is safe to use pulse dose methylprednisolone infusions to manage acute disabling relapses during pregnancy and breastfeeding. However, its use during the first trimester of pregnancy is still controversial. Women with MS should b...Continue Reading

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Sep 6, 2020·Multiple Sclerosis and Related Disorders·Washigton Luiz Gomes de Medeiros JuniorMarcus Vinicius Magno Gonçalves
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Methods Mentioned

BETA
contraception
cesarean section
pregnancy test

Software Mentioned

Embase

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