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Pregnancy and Multiple Sclerosis: An Update on the Disease Modifying Treatment Strategy and a Review of Pregnancy’s Impact on Disease Activity

1
Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
2
Clinic of Obstetrics and Gynaecology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
*
Author to whom correspondence should be addressed.
Medicina 2020, 56(2), 49; https://doi.org/10.3390/medicina56020049
Received: 23 November 2019 / Revised: 17 December 2019 / Accepted: 16 January 2020 / Published: 21 January 2020
Pregnancy rates are rapidly increasing among women of reproductive age diagnosed with multiple sclerosis (MS). Through pre-conception, pregnancy and post-partum periods, there is a need for disease control management, to decrease chances of MS relapses while avoiding potential risks to the mother and the fetus. However, pregnancy is not always compatible with the available highly effective MS treatments. This narrative review provides the aspects of pregnancy’s outcomes and the impact on disease activity, choices of anesthesia and the management of relapses during the pregnancy and breastfeeding period. Available disease modifying treatment is discussed in the article with new data supporting the strategy of continuing natalizumab after conception, as it is related to a decreased risk of MS relapses during the pregnancy and postpartum period. View Full-Text
Keywords: pregnancy; multiple sclerosis; relapses; breastfeeding; disease modifying therapy pregnancy; multiple sclerosis; relapses; breastfeeding; disease modifying therapy
MDPI and ACS Style

Varytė, G.; Zakarevičienė, J.; Ramašauskaitė, D.; Laužikienė, D.; Arlauskienė, A. Pregnancy and Multiple Sclerosis: An Update on the Disease Modifying Treatment Strategy and a Review of Pregnancy’s Impact on Disease Activity. Medicina 2020, 56, 49.

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