Pregravid preparation, pregnancy and childbirth, especially the course of the postpartum period in patients with multiple sclerosis (literature review)

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (2) ◽  
pp. 30-34
Author(s):  
Anastasia D. Kupina ◽  
Yuriy A. Petrov
Keyword(s):  
Multiple Sclerosis ◽  
Postpartum Period ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Disease Etiology ◽  
Pubmed Central ◽  
Pregnancy And Childbirth ◽  
Autoimmune Inflammation ◽  
New Ideas ◽  
Chronic Autoimmune Disease

Multiple sclerosis (MS) is a chronic autoimmune disease characterized by the formation of lesions in the white matter as a result of autoimmune inflammation, neurodegeneration and demyelination and leading to severe disability of patients. Women get sick more often than men; young women of reproductive age account for about 2/3 of all MS patients. It was established that pregnancy and childbirth with MS have a beneficial effect on the course of the disease, however, patients with MS need pregravid preparation, which will reduce the risk of exacerbations. Exacerbations are observed in most cases during the first 36 months of the postpartum period, which is associated with a change in hormonal status, emotional and physical stress on the womans body, and also with the cessation of physiological immunosuppression in a pregnant woman. The analysis of modern literature sources on the issues of pregravid preparation, pregnancy and childbirth, and the features of postpartum period in multiple sclerosis, as well as new ideas concerning the disease etiology and pathogenesis. 47 literature sources (national and foreign) were analyzed using various databases (PubMed, PubMed Central, Google Scholar, UpToDate).

scholarly journals Recomendações Sobre a Abordagem da Esclerose Múltipla na Gravidez, Parto e Pós-Parto: Posição de Consenso do Grupo de Estudos de Esclerose Múltipla e da Sociedade Portuguesa de Obstetrícia e Medicina Materno-Fetal

2018 ◽  
Vol 31 (12) ◽  
pp. 785
Author(s):  
Sónia Batista ◽  
Ana Martins da Silva ◽  
Maria José Sá ◽  
Lívia Sousa ◽  
João De Sá ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Young Women ◽  
Postpartum Period ◽  
State Of The Art ◽  
Healthcare Providers ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Disease Modifying Therapies ◽  
Multiple Sclerosis Patients

Multiple sclerosis typically affects young women of reproductive age. Therefore, all healthcare providers involved in the follow-up of multiple sclerosis patients must be prepared to discuss pregnancy and breastfeeding issues, and provide the best possible counselling. However, there are still many doubts and heterogeneous clinical approaches partly due to the lack of consensus and guidelines. Concerning the handling of disease modifying therapies during pregnancy and the postpartum period, uncertainties have been complicated by the increase in recent years of the number of available treatments. This article aims to present the state-of-the-art and provide guidance based on the best level of available evidence and expert opinion regarding the management of multiple sclerosis patients at different stages: pregnancy planning, pregnancy, partum, and the postpartum period.

Pregnancy in patients with multiple sclerosis

2021 ◽  
pp. jim-2020-001609
Author(s):  
Borros M Arneth
Keyword(s):  
Multiple Sclerosis ◽  
Autoimmune Disorder ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Research Results ◽  
Search Terms ◽  
Fetal Complications ◽  
Relapse Rates

Multiple sclerosis (MS) is an autoimmune disorder that affects ~2.5 million people globally. Women of reproductive age are highly susceptible to this disease. This study aims to explore the association between MS and pregnancy. Articles related to the topic under investigation were identified; the search terms included “pregnancy”, “multiple sclerosis”, “MS”, and “women”. Only articles published between 2010 and 2020 were included in the review. This review shows that researchers have attempted to explore the link between pregnancy and MS, and the results from previous studies indicate that pregnancy reduces the risk of MS relapse. However, evidence suggesting that pregnancy can affect the long-term progression of MS is lacking. The research results also indicate that MS does not increase the risk of maternal and fetal complications. MS remains a serious autoimmune disorder that affects many women worldwide. The data gathered during this review indicate that a significant correlation exists between pregnancy and MS relapse rates. The findings presented in this review can aid in the management of MS during pregnancy. Furthermore, these research results provide vital insights that caregivers can use to monitor patients with MS during pregnancy.

scholarly journals Pregnancy progression, childbirth and postpartum period in women on the preclinical stage and against the background of multiple sclerosis in sporadic and family forms

2020 ◽  
pp. 36-41
Author(s):  
Tetiana Pohuliaieva
Keyword(s):  
Multiple Sclerosis ◽  
Postpartum Period ◽  
Disease Onset ◽  
Integrated Analysis ◽  
Preclinical Stage ◽  
Pregnancy And Childbirth ◽  
Family Form ◽  
Familial Form ◽  
Group 2 ◽  
Group 1

For the fi rst time in Ukraine, was explored the eff ect of pregnancy, childbirth and the postpartum period on the further course of multiple sclerosis (MS) in sporadic and family forms of women giving birth at the preclinical stage (group 1) and against the background of the disease (group 2). Through the use of questioning method and clinical and neurological examination the following phenomena were studied. Namely, premonitory history; features of the course of the disease; the duration between labor and development of the onset of the illness in women of the 1st group and between the onset and labor in women of the 2nd group; obstetric and gynecological history; the eff ect of pregnancy and childbirth on the further course of MS. A total of 82 women were examined, 51 of them were giving birth at preclinical stage (group 1) and 31 — against the background of MS (group 2). In the 1st group with remitting course (RC), 26 women had a sporadic form and 5 — a family form; with progressive course (PC) — in 14 — sporadic and in 6 — family form. In the 2nd group with RC, 23 women had sporadic and 1 family form; with PC — 6 had sporadic and 1 family. Research has shown, the disease of majority of women from the first group has been developed after childbirth. Women from the second group with RC were giving birth most often after 5—10 years of the disease onset; with PC — after more than 10 years. According to the obstetric and gynecological history, differences were obtained during pregnancy, childbirth and the postpartum period between two groups of women with different types of course. An assessment of the effects of pregnancy, childbirth and the postpartum period of women from the 2nd group made it possible to identify criteria for various options for the further course of MS (such as improvement, stabilization, improvement through worsening, worsening), which are closely interrelated with the types of course of the disease. To sum up, an integrated analysis of the above mentioned outcome shows a positive eff ect of pregnancy and childbirth in the vast majority of women with RC and a high incidence of decline of women with PC. Key words: multiple sclerosis, types of course, sporadic and familial form, pregnancy and childbirth, obstetric and gynecological history, complications during pregnancy and childbirth

A modern view on the etiology, diagnosis, treatment and prevention of the adhesive process of the pelvic organs in women of reproductive age

2020 ◽  
pp. 91-99
Author(s):  
T.G. Romanenko ◽  
◽  
P.F. Shaganov ◽  
Keyword(s):  
Pelvic Pain ◽  
Reproductive Age ◽  
Social Significance ◽  
Women Of Reproductive Age ◽  
Disease Etiology ◽  
Tissue Ischemia ◽  
Collagen Formation ◽  
Proinflammatory Mediators ◽  
Initial Symptoms ◽  
Wide Range

The article presents a review of the literature in recent years on the problem of peritoneal pelvic adhesions in women of reproductive age. The main issues of etiology and pathogenesis of peritoneal pelvic adhesions as one of the leading causes of reproductive dysfunction, chronic pelvic pain and surgical complications in patients of reproductive age are highlighted. It has been shown that the main etiological preconditions for formation of adhesions and the development of adhesive intestinal obstruction are a peritoneal injury, intraabdominal bleeding, presence of infection, influence of various aggressive substances, local antibiotic therapy, and regional tissue ischemia. Peritoneal commissures have high health and social significance due to a wide range of surgical procedures causing peritoneal trauma and to a high frequency of adhesive process. Pelvic adhesion is a dynamic differentiated cell vascularized structure. Development of an active inflammatory process, which involving cells and proinflammatory mediators may be into a stage of tissue remodeling, collagen formation, that is the initial symptoms of adhesions. A vicious circle and a cascade of mutually supporting changes leads to adhesive disease and patients’ disability. Whatever reasons of adhesions are, ones are a major cause of pelvic pain, infertility and ovarian failure. Though the researches of the pathophysiological mechanisms of growth of adhesions are going on the attempts to determine effective methods to prevent adhesions do not rule to expected results. Keywords: peritoneal adhesions, adhesive disease, etiology, pathogenesis, prevention, treatment, reproductive age.

scholarly journals Etiopathogenetic risk factors for stroke in pregnant women

2019 ◽  
Vol 13 (3) ◽  
pp. 217-226 ◽  
Author(s):  
E. A. Bayanduryan ◽  
N. V. Samburova ◽  
E. V. Anichkova ◽  
A. S. Shkoda ◽  
V. O. Bitsadze
Keyword(s):  
Risk Factors ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Pregnant Women ◽  
Postpartum Period ◽  
Reproductive Age ◽  
Physiological Changes ◽  
Women Of Reproductive Age ◽  
Cerebrovascular Accidents ◽  
Thrombotic Complications

Stroke is a severe thrombotic condition that can occur in women of reproductive age during their pregnancy. Physiological changes that occur during gestation, childbirth and the postpartum period predispose a woman to the development of thrombotic complications. However, the true causes of cerebrovascular accidents are not fully understood. More than 50 % of strokes occur in the absence of obvious risk factors. The article reviews etiological and pathogenetic mechanisms of cerebral blood flow disorders and factors contributing to this condition in pregnant women.

scholarly journals Restoring Reproductive Function In Overweight And Obese Women Of Childbearing Age

2020 ◽  
Vol 2 (08) ◽  
pp. 77-81
Author(s):  
Hamdamova M. T. ◽  
Jurakulova Z. A
Keyword(s):  
Negative Impact ◽  
Reproductive Function ◽  
Diet Therapy ◽  
Overweight And Obesity ◽  
Reproductive Age ◽  
Obese Women ◽  
Childbearing Age ◽  
Women Of Reproductive Age ◽  
Pregnancy And Childbirth ◽  
Group 2

The prevalence of overweight and obesity among women in Uzbekistan is 31.7 %. There is an annual increase in people with obesity. The facts of the negative impact of fat mass on the hormonal system and, as a result, a decrease in fertility in women are not in doubt. The purpose of this study was to evaluate the results of Metformin use in overweight and obese women of reproductive age. The study included 45 women of reproductive age who could not reduce weight with diet therapy. All patients were divided into three groups: group 1-planning pregnancy (n = 15), group 2 – having abnormal weight gain after childbirth (n = 15), group 3 – having overweight and obesity not related to pregnancy and childbirth (n = 15). Weight loss while taking Metformin increases fertility and should be performed in obese women as pre-gravidar training.

scholarly journals Short-course Benznidazole Treatment to Reduce Trypanosoma cruzi Parasitic Load in Women of Reproductive Age (BETTY): A Non-inferiority Randomized Controlled Trial Study Protocol

2020 ◽  
Author(s):  
María Luisa Cafferata ◽  
María Ayelen Toscani ◽  
Fernando Althabe ◽  
Jose M. Belizan ◽  
Eduardo Bergel ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Side Effects ◽  
Trypanosoma Cruzi ◽  
Postpartum Period ◽  
Low Dose ◽  
Controlled Trial ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Randomized Controlled ◽  
Parasitic Load

Abstract Background Retrospective observational studies suggest that transmission of Trypanosoma cruzi does not occur in treated women when pregnant later in life. The level of parasitemia is a known risk factor for congenital transmission. Benznidazole (BZN) is the drug of choice for preconceptional treatment to reduce parasitic load. The fear of treatment-related side effects limits the implementation of the Argentine guideline recommending BZN 60d/300mg (or equivalent) treatment of T. cruzi seropositive women during the postpartum period to prevent transmission in a future pregnancy. A short and low dose BZN treatment might reduce major side effects and increase compliance, but its efficacy to reduce T. cruzi parasitic load compared to the standard 60d/300mg course is not yet established. Clinical trials testing alternative BZN courses among women of reproductive age are urgently needed.Methods and design We are proposing to perform a double-blinded, non-inferiority randomized controlled trial comparing a short low dose 30-day treatment with BZN 150mg/day (30d/150mg) vs. BZN 60d/300mg. We will recruit not previously treated T. cruzi seropositive women with a live birth during the postpartum period in Argentina, randomize them at six months postpartum, and follow them up with the following specific aims:Specific aim 1: to measure the effect of BZN 30d/150mg compared to 60d/300mg preconceptional treatment on parasitic load measured by the frequency of positive Polymerase Chain Reaction (PCR) (primary outcome) and by real-time quantitative PCR (qPCR), immediately and 10 months after treatment.Specific aim 2: to measure the frequency of serious adverse events and/or any adverse event leading to treatment interruption.Trial registration: ClinicalTrials.gov. Identifier: NCT03672487. Registered 14 September 2018, https://clinicaltrials.gov/ct2/show/NCT03672487?recrs=a&cond=Chagas+Disease&cntry=AR&draw=2&rank=3

scholarly journals Uterine leiomyoma in women of reproductive age: pregnancy and childbirth management (Literature review)

2021 ◽  
Vol 3 ◽  
pp. 48-56
Author(s):  
О.V. Golyanovskiy ◽  
K.V. Supruniuk ◽  
S.V. Frolov
Keyword(s):  
Adverse Effect ◽  
Surgical Treatment ◽  
Literature Review ◽  
Uterine Leiomyoma ◽  
Reproductive Age ◽  
Insufficient Data ◽  
Women Of Reproductive Age ◽  
Pregnancy And Childbirth ◽  
Management Literature ◽  
Accurate Indicator

The article presents a review of the current literature on the problem of uterine leiomyoma (UL) in women of reproductive age during pregnancy and childbirth. We studied the main issues of uterine leiomyoma etiology and pathogenesis, as one of the leading causes of reproductive dysfunction and possible complications during pregnancy and childbirth.UL is the most common tumor of the female genitalia and occurs in 20–30% of women of reproductive age. It is impossible to determine a more accurate indicator of this pathology, given the asymptomatic course of more than 70% of cases and irregular consultations by obstetricians and gynecologists.There is evidence that uterine leiomyoma is associated with infertility in only 5–10% of cases, but only 2–3% of cases when all other causes are ruled out. The submucosal node has the most adverse effect on fertility and reduces the implantation frequency by 72% and increases the miscarriage risk by 60%. Subserous LM affects fertility to a lesser extent than submucosal LM, but large nodules can lead to infertility requiring surgical treatment. An individual approach to the treatment of women with intramural LM is required, as there is insufficient data on the node effect on fertility.The most common complications of pregnancy, childbirth and the postpartum period in women with uterine leiomyoma in 22–58% of cases are late preeclampsia, fetoplacental insufficiency, anemia of pregnancy, fetal growth restriction, incorrect position and presentation of the fetus. Pregnancy also adversely affects UL, leading to acute secondary changes and rapid tumor growth, which in turn can lead to severe obstetric complications.

scholarly journals What’s new about multiple sclerosis and pregnancy?

2021 ◽  
Vol 16 (2) ◽  
pp. 158-162
Author(s):  
Ana Turcu DUMINICA ◽  
◽  
Nicolae GICA ◽  
Radu BOTEZATU ◽  
Anca Marina CIOBANU ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Pregnant Woman ◽  
Postpartum Period ◽  
Mode Of Delivery ◽  
Pregnancy Rates ◽  
Reproductive Age ◽  
Age Group ◽  
Current Review ◽  
Fetal Complications ◽  
Reproductive Age Group

Nowadays, women diagnosed with multiple sclerosis and belonging to the reproductive age group have high pregnancy rates, thus increasing the need of a careful pregnancy management in order to avoid maternal and fetal complications. The challenge of the chosen subject consists in identifying the available treatment that can be used during pregnancy time, emphasizing the need of a rigorous care during the preconceptional and postpartum period. The aim of the current review is to describe the management of a pregnant woman diagnosed with multiple sclerosis, in regards of treatment, anesthesia, mode of delivery and management and prevention of relapses during the postpartum period.

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