Monday, July 25, 2016

Q: 24 year old female is admitted to ICU with exacerbation of Multiple Sclerosis (MS). As patient is getting ready to get transfer out of ICU, she asked your advice about her plan to get pregnant in view of her underlying disease

A) Advise her against pregnancy
B) Encourage her for pregnancy
C) Recommend 2 years of resting period
D) Recommend stable serial MRIs before pregnancy
E) Advise her C-section and avoid normal vaginal delivery 

Answer: B

Pregnancy is actually found to be protective in MS, as it decreases the number of relapses, particularly in the second and third trimesters. MS does not cause spontaneous abortions or congenital malformations. Though there are reports that MS relapse rates may be higher in the postpartum period but overall it does not cause any increase morbidity or mortality. Labor and delivery are usually the same as in other women. Though it is always advisable to continue neurologist care during pregnancy for the management of medications.

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