Multiple Sclerosis

2017 ◽  
Author(s):  
Tamara B. Kaplan ◽  
Marcelo Matiello
Keyword(s):  
Multiple Sclerosis ◽  
Breast Feeding ◽  
Relapse Rate ◽  
Large Scale ◽  
First Trimester ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Third Trimester ◽  
Disease Modifying Therapies ◽  
Animal Data

Multiple sclerosis (MS) often affects women of childbearing age. There are many issues to consider when counseling women about their disease and treatment during this time. The Pregnancy in Multiple Sclerosis (PRIMS) study, published in 1998, is the best large-scale prospective study published to date. Based on this trial, and those that followed, it is recognized that the rate of relapse in MS decreases during pregnancy, especially during the third trimester, but there is a significant increase in relapse rate in the first three months postpartum. If relapses do occur during pregnancy, women are often treated with methylprednisolone, but this is generally avoided in the first trimester. Disease-modifying therapies (DMTs) are usually discontinued during preconception, pregnancy, and while breast-feeding. DMTs are classified under different FDA pregnancy categories based on human and animal data. Breast-feeding may influence postpartum relapse rate, but the true effect continues to be debated.

scholarly journals The Role of Postpartum Intravenous Corticosteroids in the Prevention of Relapses in Multiple Sclerosis

2011 ◽  
Vol 13 (2) ◽  
pp. 91-93 ◽  
Author(s):  
Jose Avila-Ornelas ◽  
Mirla Avila ◽  
Milena Stosic ◽  
Liliana Robles ◽  
Pilar Guillermo Prieto ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Retrospective Study ◽  
Relapse Rate ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Intravenous Methylprednisolone ◽  
Secondary Progressive ◽  
Relapsing Remitting ◽  
The Difference

Multiple sclerosis (MS) is most prevalent in women of childbearing age. It is well established that the relapse rate decreases during pregnancy but increases significantly during the first postpartum trimester. The objective of this retrospective study was to evaluate the effectiveness of the administration of 1 g of intravenous methylprednisolone (IVMP) after delivery in the prevention of MS relapses. The study involved 47 women with one or more documented pregnancies; each pregnancy was treated as a separate case. There were 50 cases with relapsing-remitting MS and 2 with secondary progressive MS. The cases were divided into two groups: the IVMP group (those who received 1 g of IVMP after delivery) and the no-IVMP group (those who did not receive IVMP after delivery). There were 39 cases in the IVMP group and 13 in the no-IVMP group. During the first postpartum trimester, relapses occurred in 17.9% of the IVMP group, compared with 46.2% of the no-IVMP group (P = .0448). The difference in relapse percentage between the two groups during the second and third postpartum trimesters was not statistically significant. Our study shows a statistically significant benefit of postpartum IVMP administration in reducing MS relapses.

scholarly journals Ingresos en UCI por causas obstétricas

2018 ◽  
Vol 18 (1) ◽  
pp. 304-345 ◽  
Author(s):  
Luana Feitosa Mourão ◽  
Igor Cordeiro Mendes ◽  
Antonio Dean Barbosa Marques ◽  
Virna Ribeiro Feitosa Cestari ◽  
Roussana Maria Barreto de Brito Braga
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
First Trimester ◽  
Lung Edema ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Cross Sectional ◽  
First Trimester Of Pregnancy ◽  
Terapia Intensiva ◽  
Las Mujeres

Objetivou-se analisar as internações de mulheres em idade fértil em uma Unidade de Terapia Intensiva Obstétrica. Estudo transversal, documental e retrospectivo, realizado em uma Unidade de Terapia Intensiva Obstétrica, localizada em Fortaleza/Ceará, com a presença de mulheres em idade fértil admitidas na unidade no ano de 2016. Os dados foram coletados dos prontuários que atenderam aos critérios de inclusão, durante o mês de abril de 2017, mediante um formulário semiestruturado e analisados por meio de estatística descritiva, sendo incluídos 106 prontuários. A maioria das mulheres tinham faixa etária entre 20 a 29 anos, pardas, em união estável, com ensino médio completo, primíperas, com início do pré-natal no 1º trimestre gestacional, com 4 a 6 consultas. Dentre as causas obstétricas diretas (61,1%) as principais foram Eclâmpsia (34,4%), Síndrome de Hellp (15,1%) e Pré-eclâmpsia grave (11%) e para as causas obstétricas indiretas (38,9%) destacam-se Insuficiência renal (13,5%), Edema agudo de pulmão (11,5%) e Cardiopatia (9,6%). Os dados revelam uma linha ténue no que concerne a atenção a saúde da mulheres dentro do ciclo gravídico-puerperal. Su objetivo es analizar los ingresos de mujeres en edad fértil en una Unidad de Cuidados Intensivos Obstétrica. Estudio transversal, documental y retrospectivo, realizado en una Unidad de Cuidados Intensivos Obstétrica, ubicada en Fortaleza / Ceará, con la presencia de mujeres en edad fértil admitidas en la unidad en el año 2016. Los datos fueron recolectados de los registros que atendieron a los criterios de inclusión. Durante el mes de abril de 2017, mediante un formulario semiestructurado y analizado por medio de estadística descriptiva, siendo incluidos 106 registros. La mayoría de las mujeres tenía un grupo de edad entre 20 y 29 años, pardas, en unión estable, con enseñanza media completa, primíperas, con inicio del prenatal en el primer trimestre gestacional, con 4 a 6 consultas. Entre las causas obstétricas directas (61,1%) las principales fueron Eclampsia (34,4%), Síndrome de Hellp (15,1%) y Pre-eclampsia grave (11%) y para las causas obstétricas indirectas (38,9 (%), Se observan las siguientes: Insuficiencia renal (13,5%), Edema agudo de pulmón (11,5%) y Cardiopatía (9,6%). Los datos revelan una línea tenue en lo que concierne a la atención a la salud de las mujeres dentro del ciclo gravídico-puerperal. The objective was to analyze the admission of women of childbearing age to an Obstetric Intensive Care Unit. A cross-sectional, documentary and retrospective study was carried out in an Obstetric Intensive Care Unit, located in Fortaleza/Ceará, with women of childbearing age admitted to the unit in 2016. Data were collected from 106 medical records that met the inclusion criteria during the month of April 2017, using a semi-structured form, and analyzed by means of descriptive statistics. The majority of the women were between 20 and 29 years old, common-law married, with complete secondary education, primiparous, had initiated prenatal care in the first trimester of pregnancy, and attended 4 to 6 consultations. Among the direct obstetric causes (61.1%), the most frequent were Eclampsia (34.4%), HELLP syndrome (15.1%) and Severe preeclampsia (11%). The indirect obstetric causes (38.9%) included Renal insufficiency (13.5%), Acute lung edema (11.5%) and Heart disease (9.6%). Data revealed a fragile health care for women within the pregnant-puerperal cycle.

Interferon-beta exposure during first trimester is safe in women with multiple sclerosis—A prospective cohort study from the German Multiple Sclerosis and Pregnancy Registry

2016 ◽  
Vol 22 (6) ◽  
pp. 801-809 ◽  
Author(s):  
Sandra Thiel ◽  
Annette Langer-Gould ◽  
Milena Rockhoff ◽  
Aiden Haghikia ◽  
Annette Queisser-Wahrendorf ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Birth Weight ◽  
Preterm Birth ◽  
Pregnancy Outcomes ◽  
Interferon Beta ◽  
First Trimester ◽  
Disease Modifying Therapies ◽  
Disease Modifying ◽  
Multiple Sclerosis Patients ◽  
Pregnancy Registry

Background: Available data suggest that pregnancy exposure to interferon-beta might result in lower mean birth weight and preterm birth. Objective: To determine the effect of interferon-beta exposure during pregnancy on pregnancy outcomes in multiple sclerosis patients. Methods: We compared the pregnancy outcomes of women exposed to interferon-beta with pregnancies unexposed to disease-modifying therapies. Women were enrolled into the German Multiple Sclerosis and Pregnancy Registry. A standardized questionnaire was administered during pregnancy and postpartum. Detailed information on course of multiple sclerosis and pregnancy, concomitant medications, delivery, and outcome of pregnancy was obtained. Results: We collected data on 251 pregnancies exposed to interferon-beta and 194 unexposed to disease-modifying therapies. In all, 246 (98.01%) women discontinued interferon-beta treatment during first trimester. No differences regarding mean birth weight (exposed: 3272.28 ± 563.61 g; unexposed: 3267.46 ± 609.81 g), mean birth length (exposed: 50.73 ± 3.30 cm; unexposed: 50.88 ± 3.45 cm), preterm birth ( p = 0.187), spontaneous abortion ( p = 0.304), and congenital anomalies ( p = 0.197) were observed between the two groups. Conclusions: Interferon-beta exposure during early pregnancy does not influence the mean birth weight, risk of preterm birth, or other adverse pregnancy outcomes. Our study provides further reassurance that interferon-beta treatment can be safely continued up until women become pregnant.

Breast-Feeding and Serum p,p′DDT Levels among Mexican Women of Childbearing Age: A Pilot Study

2001 ◽  
Vol 87 (3) ◽  
pp. 131-135 ◽  
Author(s):  
Lizbeth López-Carrillo ◽  
Luisa Torres-Sánchez ◽  
Jacqueline Moline ◽  
Karen Ireland ◽  
Mary S. Wolff
Keyword(s):  
Pilot Study ◽  
Breast Feeding ◽  
Mexican Women ◽  
Women Of Childbearing Age ◽  
Childbearing Age

First trimester interleukin 8 levels are associated with postpartum relapse in multiple sclerosis

2009 ◽  
Vol 15 (11) ◽  
pp. 1356-1358 ◽  
Author(s):  
Rinze F Neuteboom ◽  
Evert Verbraak ◽  
Jane SA Voerman ◽  
Marjan van Meurs ◽  
Eric AP Steegers ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
High Risk ◽  
Disease Activity ◽  
Serum Levels ◽  
First Trimester ◽  
Interleukin 8 ◽  
Disease Course ◽  
Third Trimester ◽  
The Third

Pregnancy has an ameliorating effect on multiple sclerosis (MS), but directly after delivery the risk of a relapse is increased. The pro-inflammatory chemokine interleukin 8 is associated with disease activity. We aimed to investigate whether pregnancy-induced fluctuations of interleukin 8 correlate with periods of enhanced and diminished disease activity. Thirty-six women with MS were prospectively studied before, during and after pregnancy. Serum levels of interleukin 8 were significantly decreased during the third trimester (p = 0.03). High first trimester serum levels of interleukin 8 were associated with a high risk of postpartum relapse (p = 0.007). These results help us to further understand the altered disease course during pregnancy.

scholarly journals Diagnosis of Pregnant Women with Seizures at Tikur Anbessa Hospital

2021 ◽  
pp. 1-6
Author(s):  
Beliyu Ejo Kebede ◽  
◽  
Meseret Adugna Geleta ◽  
Keyword(s):  
Antiepileptic Drugs ◽  
Breast Feeding ◽  
Dual Therapy ◽  
Drug Regimen ◽  
Prescribing Patterns ◽  
Seizure Type ◽  
Healthy Children ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Complex Partial Seizures

Information is yet scanty concerning current antiepileptic drugs prescribing patterns for women of childbearing age with epilepsy. Most women with epilepsy can give birth to perfectly healthy children after uneventful pregnancies. Best approach to management of epilepsy in pregnancy requires knowledge of the teratogenic effects of antiepileptic drugs, of the risks with uncontrolled seizures. Understanding the effects of pregnancy on seizure control and of gestational effects on antiepileptic drugs disposition is useful in early clinical diagnosis and patient management systems. We evaluated utilization of antiepileptic drugs among women of childbearing age against pre-set standards in epilepsy clinic of Tikur Anbessa Special and Referral Hospital from May 2017 to May 2018. The mean age of the women were 24.92± 6.54, where majority 217 (56.5%) of them aged between 15-25. Eighty-five (22.1%) of the women diagnosed with epilepsy were found to be pregnant, among them 20(5.2%) were breast-feeding. Generalized tonic clonic seizure (62.8%) was found to be the commonest seizure type diagnosed followed by unidentified or uncategorized seizures (16.7%), focal seizures (11.5%), and complex partial seizures (6.3%). Among the variety of anti-epileptic drug regimen or combinations used to treat epilepsy in 384 mothers, monotherapy 259 (67.4%) was the commonest drug regimen prescribed followed by dual therapy 97 (25.3%), and polytherapy 28 (7.3%). We here concluded that Valproic acid 44(51.8%) followed by phenytoin 36(42.4%) and phenobarbital 17(20%) were commonly given for breast-feeding women at Tikur Anbessa hospital.

scholarly journals Penyuluhan tentang Gambaran Diabetes Melitus pada Wanita Usia Subur di Desa Penyengat Olak Kecamatan Jambi Luar Kota Kabupaten Muaro Jambi Tahun 2019

2021 ◽  
Vol 3 (1) ◽  
pp. 6
Author(s):  
Dewi Nopiska Lilis ◽  
Imelda Imelda
Keyword(s):  
Diabetes Mellitus ◽  
Health Knowledge ◽  
First Trimester ◽  
Reproductive Age ◽  
Congenital Defects ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Administrative Preparation ◽  
Reading Material ◽  
Condition Of Women

The percentage of diabetes mellitus in women of reproductive age needs to be monitored and watched out for. Women with diabetes before pregnancy are more likely to have babies with congenital defects if their glycemic control is below optimal during the first trimester of pregnancy. Target and outcome: to increase knowledge and mindset on the health of women of childbearing age. The goal is to increase health knowledge about the picture of diabetes mellitus in women of childbearing age and changes in behavior from information provided through counseling and giving leaflets as reading material to get used to living healthy and away from things that aggravate health conditions, especially the picture of diabetes mellitus in women of childbearing age. Implementation methods: administrative preparation, socialization, presentation by providing counseling and distribution of leaflets about the description of diabetes mellitus to women of childbearing age in Penyegat Olak Village, Jambi Sub-district, Outer City, Muaro Jambi Regency in 2019, and finally a discussion. Results: Implementation of counseling and distribution of leaflets on the description of diabetes mellitus was given to 40 women of childbearing age. Evaluation carried out after the mother has been given counseling can explain an increase in health knowledge about the picture of diabetes mellitus in women of childbearing age. Behavior changes in women of childbearing age include implementing good things, getting used to living healthy and staying away from things that aggravate the condition of women with diabetes mellitus

Acute Myocardial Infarction in the First Trimester of Pregnancy

2005 ◽  
Vol 13 (2) ◽  
pp. 175-177 ◽  
Author(s):  
Amar M Salam
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Myocardial Infarction ◽  
First Trimester ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Anterior Myocardial Infarction ◽  
First Trimester Of Pregnancy ◽  
Artery Disease ◽  
In Pregnancy

Acute myocardial infarction rarely occurs in women during pregnancy. However, when it does occur, it usually carries a high risk of maternal and perinatal mortality. There is a lack of awareness that this condition can occur in pregnancy since coronary artery disease is uncommon in women of childbearing age. In this report, a 43-year-old lady with acute anterior myocardial infarction in her eighth week of pregnancy is presented. The challenges involved in diagnosing this condition in pregnancy are briefly discussed.

scholarly journals The risk of polypharmacy, comorbidities and drug–drug interactions in women of childbearing age with multiple sclerosis

2020 ◽  
Vol 13 ◽  
pp. 175628642096950
Author(s):  
Niklas Frahm ◽  
Michael Hecker ◽  
Silvan Elias Langhorst ◽  
Pegah Mashhadiakbar ◽  
Marie-Celine Haker ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Drug Interactions ◽  
Clinical Decision ◽  
Women Of Childbearing Age ◽  
Potential Ddis ◽  
Childbearing Age ◽  
Exact Test ◽  
Patient Interviews ◽  
Concurrent Use ◽  
Degree Of Disability

Background and Aims: Multiple sclerosis (MS) is the most common neuroimmunological disease of the central nervous system in young adults. Despite recommended contraception, unplanned pregnancies can occur in women of childbearing age with MS. MS- and comorbidities-related multimedication in these patients represents a potential risk. We aimed to raise awareness regarding the frequency of polypharmacy and drug–drug interactions (DDIs) in female MS patients of childbearing age. Methods: Sociodemographic, clinical and pharmaceutical data were collected through patient records, clinical investigations and structured patient interviews of 131 women with MS. The clinical decision support software MediQ was used to identify potential DDIs. A medication and DDI profile of the study population was created by statistical analysis of the recorded data. Results: Of the 131 female MS patients, 41.2% were affected by polypharmacy (concurrent use of ⩾5 drugs). Polypharmacy was associated with higher age, higher degree of disability, chronic progressive MS disease course and comorbidities. With an average intake of 4.2 drugs per patient, a total of 1033 potential DDIs were identified. Clinically relevant DDIs were significantly more frequent in patients with polypharmacy than in patients without polypharmacy (31.5% versus 5.2%; Fisher’s exact test: p < 0.001). Conclusion: For the first time, a comprehensive range of potential DDIs in women of childbearing age with MS is presented. Polypharmacy is associated with the occurrence of clinically relevant DDIs. This shows the need for effective and regular screening for such interactions in order to prevent avoidable adverse effects.

Pregnancy outcome in women with multiple sclerosis: results from a prospective nationwide study in Finland

2010 ◽  
Vol 16 (8) ◽  
pp. 950-955 ◽  
Author(s):  
A. Jalkanen ◽  
A. Alanen ◽  
L. Airas ◽  
Keyword(s):  
Multiple Sclerosis ◽  
Early Pregnancy ◽  
Artificial Insemination ◽  
Pregnancy Complications ◽  
Expanded Disability Status Scale ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Nationwide Study ◽  
Medical Birth Register ◽  
Disability Status

The majority of individuals obtaining the diagnosis of multiple sclerosis are women of childbearing age. They are naturally concerned as to how multiple sclerosis affects the course of pregnancy and the developing foetus. The objective of this study was to prospectively evaluate the incidence of pregnancy complications and delivery risks, and to follow the natural course of multiple sclerosis during and after pregnancy in a cohort of Finnish patients with multiple sclerosis. Sixty-one patients with multiple sclerosis who became pregnant during the years 2003—2005 were prospectively followed-up from early pregnancy until 6 months postpartum. Multiple sclerosis relapses, Expanded Disability Status Scale rates and obstetric details were recorded. The results were compared with the statistics obtained from Finnish Medical Birth Register from the year 2004. We found that patients with multiple sclerosis were no more likely to experience pregnancy complications than Finnish pregnant women generally, but they had a greater likelihood for a need of artificial insemination (4.9% vs. 0.9%; p = 0.0009). Subjects with multiple sclerosis were more likely to undergo assisted vaginal delivery than the at-large cohort(16.4% vs. 6.5%; p = 0.0017). We conclude that pregnancy does not seem to pose a woman with multiple sclerosis to a greater risk for pregnancy complications when compared with women in general. The potential need for instrumental delivery should, however, be taken into account when planning the delivery of a mother with multiple sclerosis.

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