BibTex RIS Cite

Pregnancy and Postpartum Period in Multiple Sclerosis

Year 2011, Volume: 18 Issue: 4, 284 - 287, 01.08.2011

Abstract

Objectives: Multiple sclerosis (MS) is a chronic and immune-mediated inflammatory disease of the central nervous system. The disease particularly affects women of childbearing age. In this study we report the pregnancy and postpartum period in multiple sclerosis patients who were followed up in our clinic. Method: Retrospective data from MS patients who became pregnant at any time of disease were collected in Inonu University Turgut Ozal Medical Center, Department of Neurology Multiple sclerosis clinic. Results: Data on 110 women MS patients files were examined. There were 25 MS patients who became pregnant. 17 of 25 patients were prediagnosis group, 8 patients were after diagnosis group. Relapse rate in pregnancy was very low in our patients. There was no complications in newborns. The patients who experienced relapse usually had this relapse in 1-9 months after delivery. Conclusions: Our patients had lower relapse rate (4%) in pregnancy. In postpartum period, the relapse rate increases especially during the first three months after delivery. Key words: Multiple Sclerosis; Pregnancy; Postpartum Period.

References

  • Alonso A, Hernan MA. Temporal trends in the incidence of multiple sclerosis: a systematic review. Neurology 2008; 71: 129- 35.
  • Confavreux C, Hutchinson M, Hours MM, et al. Rate of pregnancy-related relapse in multiple sclerosis. Pregnancy in Multiple Sclerosis Group. N Engl J Med 1998; 339: 285-91.
  • Vukusic S, Confavreux C. Pregnancy and multiple sclerosis: the children of PRIMS. Clin Neurol Neurosurg 2006; 108: 266-70.
  • Abramsky O. Pregnancy and multiple sclerosis. Ann Neurol 1994; 36 Suppl: S38-S41.
  • Sadovnick AD, Eisen K, Hashimoto SA, et al. Pregnancy and multiple sclerosis. A prospective study. Arch Neurol 1994; 51: 1120-4.
  • Weinshenker BG, Hader W, Carriere W, et al. The influence of pregnancy on disability from multiple sclerosis: a population- based study in Middlesex County, Ontario. Neurology 1989; 39: 1438-40.
  • De SJ, Chapelotte M, Delalande S et al. Intravenous corticosteroids in the postpartum period for reduction of acute exacerbations in multiple sclerosis. Mult Scler 2004; 10: 596-7.
  • Haas J, Hommes OR. A dose comparison study of IVIG in postpartum relapsing-remitting multiple sclerosis. Mult Scler 2007; 13: 900-8.
  • Finkelsztejn A, Fragoso YD, Ferreira ML, et al. The Brazilian database on pregnancy in multiple sclerosis. Clin Neurol Neurosurg 2011 May;113(4):277-80.
  • Jalkanen A, Alanen A, Airas L. Finnish Multiple Sclerosis and Pregnancy Study Group. Pregnancy outcome in women with multiple sclerosis: results from a prospective nationwide study in Finland. Mult Scler 2010; 16(8):950-5.
  • Achiron A, Kishner I, Dolev M, et al. Effect of intravenous immunoglobulin treatment on pregnancy and postpartum-related relapses in multiple sclerosis. J Neurol 2004; 251: 1133-7.
  • Poser CM. Diagnostic criteria for multiple sclerosis: an addendum.Ann Neurol. 1987; 22(6): 773.
  • Polman CH, Reingold SC, Edan G, et al. Diagnostic criteria for multiple sclerosis: 2005 revisions to the "McDonald Criteria". Ann Neurol. 2005 Dec;58(6): 840-6. Review
  • Lee M, O'Brien P. Pregnancy and multiple sclerosis. J Neurol Neurosurg Psychiatry 2008; 79: 1308-11.
  • Vukusic S, Ionescu I, El-Etr M, et al. The Prevention of post- partum relapses with progestin and estradiol in multiple sclerosis (POPART'MUS) trial: rationale, objectives and state of advancement. J Neurol Sci 2009; 286: 114-8.
  • Koch M, Uyttenboogaart M, Heersema D, et al. Parity and secondary progression in multiple sclerosis. J Neurol Neurosurg Psychiatry 2009; 80: 676-8.
  • Korn-Lubetzki I, Kahana E, Cooper G, et al. Activity of multiple sclerosis during pregnancy and puerperium. Ann Neurol 1984; 16: 229-31.
  • Nazliel B. Multiple skleroz ve gebelik. Turkiye Klinikleri J Neurol 2004; 2: 216-9.
  • Ferrero S, Pretta S, Ragni N. Multiple sclerosis: management issues during pregnancy. Eur J Obstet Gynecol Reprod Biol 2004; 115: 3-9.
  • Bennett KA. Pregnancy and multiple sclerosis. Clin Obstet Gynecol 2005; 48: 38-47.
  • Dorotta IR, Schubert A. Multiple sclerosis and anesthetic implications. Curr Opin Anaesthesiol 2002; 15: 365-70.
  • Haas J. High dose IVIG in the post partum period for prevention of exacerbations in MS. Mult Scler 2000; 6 Suppl 2: S18-S20.
  • Hellwig K, Haghikia A, Agne H, et al. Protective effect of breastfeeding in postpartum relapse rate of mothers with multiple sclerosis. Arch Neurol 2009; 66: 1580-1.
  • Langer-Gould A, Huang SM, Gupta R, et al. Exclusive breastfeeding and the risk of postpartum relapses in women with multiple sclerosis. Arch Neurol 2009; 66: 958-63.
  • Kieseier BC, Wiendl H. Postpartum disease activity and breastfeeding in multiple sclerosis revisited. Neurology 2010; 75: 392-3.

Multipl Sklerozda Gebelik ve Postpartum Dönem

Year 2011, Volume: 18 Issue: 4, 284 - 287, 01.08.2011

Abstract

Amaç: Multipl skleroz (MS) merkezi sinir sisteminin kronik ve immun aracılı demiyelinizan bir hastalığıdır. Hastalık özellikle doğurganlık çağındaki kadınları etkiler. Biz bu yazımızda kendi kliniğimizde takipli MS hastalarının gebelik ve postpartum dönemdeki ataklarını inceledik. Metod: İnönü Üniversitesi Turgut Özal Tıp Merkezi Nöroloji Anabilim dalı MS polikliniğinde takipli ve hastalığın herhangi bir evresinde gebelik yaşamış MS hastalarının dosyaları retrospektif olarak incelendi. Bulgular: 110 kadın hastanın dosya incelemesi yapıldı. 25 hastanın MS tanısı almadan kısa süre önce ya da MS tanısı aldıktan sonra gebe kaldığı saptandı. 25 hastanın 17'si MS tanısından önce (tanı öncesi grup), 8'i ise MS tanısı (tanı sonrası grup) konulduktan sonra gebe kalmıştı. Gebelikte relaps oranı oldukça düşük (%4) olarak saptandı. Yeni doğanlarda herhangi bir komplikasyon izlenmedi. Postpartum dönemde atak geçiren hastaların bu atakları genellikle doğumdan sonraki ilk 1-9 ayda yaşadığı görüldü. Sonuç: Bizim hastalarımızda gebelikte atak oranı oldukça düşüktü. Postpartum dönemde atak riski özellikle ilk üç ayda artmaktadır. Anahtar Sözcükler: Multipl Skleroz; Gebelik; Postpartum Dönem.

References

  • Alonso A, Hernan MA. Temporal trends in the incidence of multiple sclerosis: a systematic review. Neurology 2008; 71: 129- 35.
  • Confavreux C, Hutchinson M, Hours MM, et al. Rate of pregnancy-related relapse in multiple sclerosis. Pregnancy in Multiple Sclerosis Group. N Engl J Med 1998; 339: 285-91.
  • Vukusic S, Confavreux C. Pregnancy and multiple sclerosis: the children of PRIMS. Clin Neurol Neurosurg 2006; 108: 266-70.
  • Abramsky O. Pregnancy and multiple sclerosis. Ann Neurol 1994; 36 Suppl: S38-S41.
  • Sadovnick AD, Eisen K, Hashimoto SA, et al. Pregnancy and multiple sclerosis. A prospective study. Arch Neurol 1994; 51: 1120-4.
  • Weinshenker BG, Hader W, Carriere W, et al. The influence of pregnancy on disability from multiple sclerosis: a population- based study in Middlesex County, Ontario. Neurology 1989; 39: 1438-40.
  • De SJ, Chapelotte M, Delalande S et al. Intravenous corticosteroids in the postpartum period for reduction of acute exacerbations in multiple sclerosis. Mult Scler 2004; 10: 596-7.
  • Haas J, Hommes OR. A dose comparison study of IVIG in postpartum relapsing-remitting multiple sclerosis. Mult Scler 2007; 13: 900-8.
  • Finkelsztejn A, Fragoso YD, Ferreira ML, et al. The Brazilian database on pregnancy in multiple sclerosis. Clin Neurol Neurosurg 2011 May;113(4):277-80.
  • Jalkanen A, Alanen A, Airas L. Finnish Multiple Sclerosis and Pregnancy Study Group. Pregnancy outcome in women with multiple sclerosis: results from a prospective nationwide study in Finland. Mult Scler 2010; 16(8):950-5.
  • Achiron A, Kishner I, Dolev M, et al. Effect of intravenous immunoglobulin treatment on pregnancy and postpartum-related relapses in multiple sclerosis. J Neurol 2004; 251: 1133-7.
  • Poser CM. Diagnostic criteria for multiple sclerosis: an addendum.Ann Neurol. 1987; 22(6): 773.
  • Polman CH, Reingold SC, Edan G, et al. Diagnostic criteria for multiple sclerosis: 2005 revisions to the "McDonald Criteria". Ann Neurol. 2005 Dec;58(6): 840-6. Review
  • Lee M, O'Brien P. Pregnancy and multiple sclerosis. J Neurol Neurosurg Psychiatry 2008; 79: 1308-11.
  • Vukusic S, Ionescu I, El-Etr M, et al. The Prevention of post- partum relapses with progestin and estradiol in multiple sclerosis (POPART'MUS) trial: rationale, objectives and state of advancement. J Neurol Sci 2009; 286: 114-8.
  • Koch M, Uyttenboogaart M, Heersema D, et al. Parity and secondary progression in multiple sclerosis. J Neurol Neurosurg Psychiatry 2009; 80: 676-8.
  • Korn-Lubetzki I, Kahana E, Cooper G, et al. Activity of multiple sclerosis during pregnancy and puerperium. Ann Neurol 1984; 16: 229-31.
  • Nazliel B. Multiple skleroz ve gebelik. Turkiye Klinikleri J Neurol 2004; 2: 216-9.
  • Ferrero S, Pretta S, Ragni N. Multiple sclerosis: management issues during pregnancy. Eur J Obstet Gynecol Reprod Biol 2004; 115: 3-9.
  • Bennett KA. Pregnancy and multiple sclerosis. Clin Obstet Gynecol 2005; 48: 38-47.
  • Dorotta IR, Schubert A. Multiple sclerosis and anesthetic implications. Curr Opin Anaesthesiol 2002; 15: 365-70.
  • Haas J. High dose IVIG in the post partum period for prevention of exacerbations in MS. Mult Scler 2000; 6 Suppl 2: S18-S20.
  • Hellwig K, Haghikia A, Agne H, et al. Protective effect of breastfeeding in postpartum relapse rate of mothers with multiple sclerosis. Arch Neurol 2009; 66: 1580-1.
  • Langer-Gould A, Huang SM, Gupta R, et al. Exclusive breastfeeding and the risk of postpartum relapses in women with multiple sclerosis. Arch Neurol 2009; 66: 958-63.
  • Kieseier BC, Wiendl H. Postpartum disease activity and breastfeeding in multiple sclerosis revisited. Neurology 2010; 75: 392-3.
There are 25 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Özden Kamışlı This is me

Sinan Gönüllü This is me

Suat Kamışlı This is me

Cemal Özcan This is me

Publication Date August 1, 2011
Published in Issue Year 2011 Volume: 18 Issue: 4

Cite

APA Kamışlı, Ö., Gönüllü, S., Kamışlı, S., Özcan, C. (2011). Multipl Sklerozda Gebelik ve Postpartum Dönem. Journal of Turgut Ozal Medical Center, 18(4), 284-287.
AMA Kamışlı Ö, Gönüllü S, Kamışlı S, Özcan C. Multipl Sklerozda Gebelik ve Postpartum Dönem. J Turgut Ozal Med Cent. August 2011;18(4):284-287.
Chicago Kamışlı, Özden, Sinan Gönüllü, Suat Kamışlı, and Cemal Özcan. “Multipl Sklerozda Gebelik Ve Postpartum Dönem”. Journal of Turgut Ozal Medical Center 18, no. 4 (August 2011): 284-87.
EndNote Kamışlı Ö, Gönüllü S, Kamışlı S, Özcan C (August 1, 2011) Multipl Sklerozda Gebelik ve Postpartum Dönem. Journal of Turgut Ozal Medical Center 18 4 284–287.
IEEE Ö. Kamışlı, S. Gönüllü, S. Kamışlı, and C. Özcan, “Multipl Sklerozda Gebelik ve Postpartum Dönem”, J Turgut Ozal Med Cent, vol. 18, no. 4, pp. 284–287, 2011.
ISNAD Kamışlı, Özden et al. “Multipl Sklerozda Gebelik Ve Postpartum Dönem”. Journal of Turgut Ozal Medical Center 18/4 (August 2011), 284-287.
JAMA Kamışlı Ö, Gönüllü S, Kamışlı S, Özcan C. Multipl Sklerozda Gebelik ve Postpartum Dönem. J Turgut Ozal Med Cent. 2011;18:284–287.
MLA Kamışlı, Özden et al. “Multipl Sklerozda Gebelik Ve Postpartum Dönem”. Journal of Turgut Ozal Medical Center, vol. 18, no. 4, 2011, pp. 284-7.
Vancouver Kamışlı Ö, Gönüllü S, Kamışlı S, Özcan C. Multipl Sklerozda Gebelik ve Postpartum Dönem. J Turgut Ozal Med Cent. 2011;18(4):284-7.