Pregnancy in the context of Multiple Sclerosis

M. Plotogea, C. Mehedințu, V. Varlas, C. Berceanu, R. Mateescu, A. Edu, Vlad Dima, C. Andreescu, A. Petca, G. Ionescu
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Abstract

Multiple Sclerosis is a chronic autoimmune neurodegenerative disorder which affects brain, spinal cord and optic nerve. During last years the perception over the disease changed dramatically, now being considered a handleable disease. The particularity of this subject is that Multiple Sclerosis is a disease which affects mostly young women, many of them not having any children at the moment of diagnosis. This article highlights the fact that women diagnosed with Multiple Sclerosis are allowed to get pregnant, and, moreover, they are encouraged to live a normal life. In most cases, disease activity freezes during pregnancy, only a small percentage of women will continue to have clinically and radiologically active disease. For those women, IFN-β and Glatiramer Acetate are the first-choice therapies that should be given. In cases when the disease is not responding to common medication, refractory to treatment forms may be successfully treated with Natalizuab, during the first and the second trimester. Breastfeeding is also encouraged, as it has a protective effect on disease progression. The main purpose of this article is to make a literature review in which to summarize the updates regarding pregnancy and postpartum management, relapses management and, also, the impact of pregnancy on Multiple Sclerosis course. The analysis was limited to articles written in English and published between August 2019 - October 2022 on PubMed, NCBI and Medical Journals.
多发性硬化症下的妊娠
多发性硬化症是一种影响大脑、脊髓和视神经的慢性自身免疫性神经退行性疾病。在过去几年中,人们对这种疾病的看法发生了巨大变化,现在被认为是一种可治疗的疾病。这个问题的特殊性在于,多发性硬化症是一种主要影响年轻女性的疾病,其中许多人在确诊时还没有孩子。这篇文章强调了这样一个事实,即被诊断患有多发性硬化症的妇女被允许怀孕,而且,她们被鼓励过正常的生活。在大多数情况下,疾病活动在怀孕期间冻结,只有一小部分妇女将继续具有临床和放射活动性疾病。对于这些女性,IFN-β和醋酸格拉替雷是首选的治疗方法。在疾病对普通药物无效的情况下,在妊娠早期和中期,用Natalizuab可以成功地治疗难治性治疗形式。母乳喂养也受到鼓励,因为它对疾病进展有保护作用。本文的主要目的是进行文献综述,总结妊娠和产后管理、复发管理以及妊娠对多发性硬化症病程的影响的最新进展。该分析仅限于2019年8月至2022年10月期间在PubMed、NCBI和医学期刊上发表的英文文章。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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