Management of MS in pregnancy reviewed in U.K. guideline

(HealthDay)—It is important to discuss family planning and pregnancy proactively in women of childbearing age who have multiple sclerosis (MS), according to a review published online Jan. 5 in Practical Neurology.

Ruth Dobson, Ph.D., from the Queen Mary University of London, and colleagues developed consensus guidelines for the treatment of MS in pregnancy in the hopes of encouraging and facilitating patient-provider discussions. The guidelines were based on available evidence from drug-specific pregnancy registers and published literature. A multidisciplinary panel of experts scored the guidelines using modified Delphi criteria.

The guidelines cover prepregnancy counseling, disease management during pregnancy, delivery and anesthetic options, postpartum advice, and specific advice regarding currently approved disease-modifying drugs. Some specific recommendations include advising women of childbearing age with MS that they should not defer or stop disease-modifying drug treatment due to pregnancy and that pregnancy does not increase the risk for worsening long-term disability. Furthermore, having MS should not influence obstetric management, including delivery. There is no evidence of reduced fertility in men or women or evidence of an increased congenital malformation or miscarriage rate associated with disease-modifying drugs up until conception.

"An independent pregnancy register of all women with MS who become pregnant, with prospective data collection on all medications and pregnancy-related outcomes is much needed," the authors write.

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