Pregnancy and Multiple Sclerosis
What Causes MS?
Multiple sclerosis (MS) is an unpredictable disease of the central nervous system and can range in severity from relatively mild all the way to totally incapacitating, sometimes ending in death. MS is an autoimmune disease, which means that the body attacks itself through its own immune system. In the case of MS, communication between the brain and other parts of the body is disrupted when the nerve-insulating myelin is destroyed. MS causes are possibly linked to a virus or perhaps environmental triggers, although it seems science has yet to nail down MS causes.
Most people experience MS symptoms between the ages of 20 and 40, just at the time when many women are considering beginning a family. Blurred or double vision, blindness in one eye, and color distortion are initial symptoms. Muscle weakness in the legs and arms along with problems with balance and coordination are also MS symptoms. In severe cases, MS can produce partial or full paralysis. Speech impediments, tremors, dizziness, and feelings of numbness (pins and needles) are also common effects of this disease.
Diagnosing and Treating MS
MS diagnosis can take some time because the disease is often difficult to pin down. An MRI is often the best way for a physician to determine whether the disease is present in a person's body. A woman with an MS diagnosis today faces a brighter picture than women who wanted to conceive and had the disease in years gone by. Current studies indicate that pregnancy is protective for women with MS and MS treatments and therapies available today enable a woman to maintain her family after the baby is born. She will likely have to go off the treatments when planning to conceive and throughout her pregnancy.
Since MS is a disease with a natural tendency to remit spontaneously, a universal treatment is elusive. There is no cure for it, so an MS prognosis varies just as the duration of the disease varies. Most people with MS lived with it for a long time before an MS diagnosis was made, and even though some people become disabled with it, it is usually not life-threatening. There are many agencies, including MS emedicine, on the internet, and The Multiple Sclerosis Society, that are able to support and educate people with the disease as well as their families. Learning how to cope and what treatments are available are important facets to understanding and living with MS.
Should I Have A Baby?
Women with MS often ask themselves if they should have a baby and the answer is that the decision is hers, based upon recognition of the impact of the disease on her life. It is important that she have support in the event it becomes necessary to have help with the child(ren), however, with today's MS treatments, many women are able to carry on with their families in a normal fashion. There is no indication that MS is a factor in pregnancy complications nor is there a link to fertility issues or congenital abnormalities. A woman with MS is just as likely to have a healthy pregnancy as any other woman. The good news for a woman with MS is that her MS symptoms will probably diminish with pregnancy because pregnancy tends to reduce immune activity and levels of natural steroids are higher in pregnant women - making the MS symptoms lessen. This doesn't mean there won't be pregnancy symptoms, though. After all, pregnancy is pregnancy for all women.
The Role of the Neurologist
The neurologist will be involved in therapy options and monitoring a woman with MS while she is trying to conceive and throughout her pregnancy. Precautions may be taken to prevent a relapse after the birth of the baby, including administering a dose of intravenous immunoglobulin (IVIG) immediately following birth. The IVIG has been shown to reduce the chance of a postpartum relapse significantly. Not all neurologists follow this protocol, some use corticosteroids and others choose to avoid interventions.
MS is not an inherited genetic disease and as such is not usually passed on to the baby in utero. Evidence indicates that there is about a 2% chance that a baby born to a parent with MS will develop the disease. To date there are no genetic or prenatal tests, nor are there any tests on newborns to determine a predisposition to multiple sclerosis.