MULTIPLE SCLEROSIS AND PREGNANCY: STATUS OF THE PROBLEM AND CLINICAL EXPERIENCE

Abstract

The aim of the study is to study the course of pregnancy, childbirth and postpartum period, the condition of newborns in patients with multiple sclerosis, and to analyze the obtained results in comparison with similar data from modern scientific and medical literature. Materials and research methods. An observational study of the course of pregnancy, childbirth, postpartum period, and the condition of newborns was conducted in 27 patients with multiple sclerosis (main group) and 56 somatically healthy pregnant women (control group). Research results and their discussion. During 10 years (2011-2020), 27 women with multiple sclerosis were observed and gave birth in the department of internal pathology of pregnant women. The average age was 28 ± 8 years. According to the duration of the disease, the patients were distributed as follows: up to 2 years - 8 (29.6%), 2-3 years - 6 (22.2%), 4-5 years - 3 (11.1%), 6 years - 4 (14.8%), 9 years - 1 (3.7%), 10 years - 3 (11.1%), 12 years - 2 (7.4%). Among all observed women, five (18.5%) had no complications during pregnancy, the remaining 22 (81.5%) had various problems. Concomitant extragenital pathology occurred in 21 women (77.8%). Childbirth on time (37-41 weeks) occurred in 24 women, premature childbirth in 33-35 weeks occurred in 3 women. 15 women (55.6%) gave birth through the natural birth canal, the remaining 12 women (44.4%) - by caesarean section. All children were born alive: 12 boys and 15 girls. 21 women gave birth to healthy children (77.8%), 3 (11.1%) had small gestational age and 2 (7.4%) had atelectatic pneumonia. Women’s misconceptions about the adverse effect of pregnancy on the coursed of multiple sclerosis, as well as the disease itself on the course of pregnancy and, possibly, the development of the fetus, is today the main obstacle to motherhood in multiple sclerosis. Understanding the relationship between pregnancy and the late development of the disease can be the basis for modern therapy of this disease, which will largely prevent the development of severe complications and disability. Conclusion. After the diagnosis of multiple sclerosis, all women of childbearing age should be counseled about pregnancy planning. Doctors must take into account the safety of medications that the patient constantly receives during pregnancy. The presence of this disease does not affect fertility.