Abstract
Background: Pregnancy in Parkinson's disease is a rare occurrence, and to date, clinical experience with its management is rather limited. In clinical practice, doubts concern mainly the impact of PD on gestation, labor, and delivery as well as the safety of dopaminergic drugs.Case and review of the literature: We report the case of a 40-year-old woman with an 8-year history of PD. In the first trimester of her pregnancy, her motor status was similar to the pre-conceptional period. In gestation week 16, her motor status dramatically worsened and she complained of predictable “off” periods in the afternoon. For this reason, her dose of L-DOPA/carbidopa was increased up to 500/125 mg per day. At 39 gestational weeks, she gave birth to a healthy girl with an Apgar score of 9 by an uncomplicated cesarean delivery. The child was not breast fed to avoid exposure to antiparkinsonian drugs. The L-DOPA/carbidopa dosage remained constant during the postpartum period. We performed a systematic review of the literature using Ovid Medline, Scopus, and PubMed (including Cochrane database). We used the search terms “Parkinson disease” AND “pregnancy.” We identified 20 studies of PD in pregnancy with a total of 37 pregnant women with PD. The most important available data concern the safety of L-DOPA therapy during pregnancy. There seems to be some risk of worsening of the condition or upcoming of new PD symptoms during or shortly after pregnancy.Conclusion: More data concerning the safety of antiparkinsonian drugs in PD treatment, as well as the effect of pregnancy on parkinsonian symptoms are needed. According to the current state of the art, L-DOPA therapy should be considered preferable to other drugs during pregnancy.
Highlights
Parkinson’s disease (PD) is the second most common neurodegenerative disorder
While PD is usually thought as a disease characterized by cardinal motor symptoms including resting tremor, slowness motor, and rigidity, a wide range of non-motor symptoms such as autonomic, sensory, sleep, and neuropsychiatric dysfunctions are widely recognized as part of the clinical manifestations (2)
About complications of pregnancy in women suffering from PD and treated with antiparkinsonian agents during gestation, Table 7 summarizes the results found in the literature
Summary
Pregnancy in Parkinson’s disease is a rare occurrence, and to date, clinical experience with its management is rather limited. Doubts concern mainly the impact of PD on gestation, labor, and delivery as well as the safety of dopaminergic drugs. In gestation week 16, her motor status dramatically worsened and she complained of predictable “off” periods in the afternoon. For this reason, her dose of L-DOPA/carbidopa was increased up to 500/125 mg per day. The most important available data concern the safety of L-DOPA therapy during pregnancy. Conclusion: More data concerning the safety of antiparkinsonian drugs in PD treatment, as well as the effect of pregnancy on parkinsonian symptoms are needed. 3. According to the current literature, L-DOPA therapy should be the best option for patients in terms of safety and efficacy
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
