ТЯЖЕЛОЕ ОБОСТРЕНИЕ РАССЕЯННОГО СКЛЕРОЗА НА ПОЗДНЕМ СРОКЕ БЕРЕМЕННОСТИ – ПРЕДСТАВЛЕНИЕ КЛИНИЧЕСКОГО СЛУЧАЯ

Abstract

The study aims to present an analysis of a clinical case of severe exacerbation of multiple sclerosis with a late gestation period in a patient with high disease activity, to assess the possibility of choosing modern methods of treating the disease, taking into account the effectiveness for the mother and the risk for the child. Material and methods. A clinical case of multiple sclerosis is presented: the anamnesis of the disease, the dynamics of symptoms during exacerbation and in its outcome, the therapeutic difficulties of managing the patient during pregnancy and the possibility of controlling the activity of the disease before and during pregnancy as well as after labor are analyzed. Results. Pulse therapy with methyl-prednisone at a dose of 1 000 mg daily, then every other day, in the amount of 7 infusions, followed by intravenous immunoglobulin, allowed to stop a severe exacerbation in a patient with a pregnancy of 34+3 weeks, with a highly active flow of multiple sclerosis, without a response to the drugs used. There were no side effects of treatment at the time of discharge from the hospital. No complications that could be attributed to the side effects of steroid treatment were found in the catamnesis of the mother and the newborn. The worsening of the neurological deficit occurred three months after labor.