THE OBSTETRIC MANAGEMENT IN PATIENTS WITH MULTIPLE SCLEROSIS

Abstract

Multiple Sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system and can influence pregnancy, childbirth and the postpartum period. The obstetric approach in women with MS requires specific care, considering both the effects of the disease and the impacts of the therapies used for its control. This review aims to discuss the particularities of obstetric care for patients with MS, addressing its clinical and therapeutic aspects. A literature review was performed using the main medical databases using the descriptors “multiple sclerosis” and “pregnancy”, using the Boolean operator “AND”. All articles published between 2015-2024 were included in the primary analysis. Pregnancy in women with MS can be influenced by the progression of the disease, the risk of exacerbations and the challenges in medication control, especially during the gestational period. Studies suggest that pregnancy may have a temporary protective effect in some women, with a decrease in flare-ups, but the postpartum period can be a critical time for relapses. In addition, the management of therapies, such as the suspension of immunosuppressive medications and the use of safe alternatives, must be carefully planned. Delivery, in general, does not present major contraindications, but requires surveillance for complications specific to MS. In conclusion, the obstetric approach in women with multiple sclerosis should be individualized, taking into account the disease activity, the patient's clinical conditions and the need for specific therapies.