Pregnancy with multiple sclerosis: The obstetricians' approach

Abstract

Multiple sclerosis (MS), an inflammatory, demyelinating disease of central nervous system, is the most common cause of neurological disability in young females. MS occurs in India but is comparatively very less as compared to the West. Due to its rarity, obstetricians do not encounter pregnancies with MS in India often. We report a case of a 21-year-old, primigravida who presented to us at 9 weeks of pregnancy. She was a diagnosed case of MS for 4 years. Later in pregnancy, she had walking and gait difficulty. No change in drug dosage was required, and patient had a static course of disease during pregnancy. The patient had an emergency cesarean section. Pregnancy in women with MS is not considered high risk anymore; however, there are some challenges such as managing disability and modifying ongoing therapy. Multi-disciplinary approach is the mainstay of management. Due to severe disability of routine activities such as walking, nursing herself and the baby, pregnancy with MS poses big management challenge. Social issues should be taken care of prior to conception in Indian perspective.

Keywords

• Cesarean section
• multiple sclerosis
• pregnancy