MS Management During Pregnancy

Some DMTs are safe to use in pregnancy and should be considered for women with highly active MS. Alternatively, planned pre-pregnancy use of a DMT with a long-lasting effect may provide effective condition control while minimizing drug exposure during pregnancy.

However, it is crucial to consult with a neurologist in all cases to ensure the best course of action tailored to individual circumstances.

Anaesthesia, including epidural anaesthesia, is safe for pregnant people with MS unless they have another complication that makes anaesthesia unsafe.

Corticosteroids can be used for the treatment of relapse in pregnancy; methylprednisolone, either orally or intravenously, is the treatment of choice because it is metabolized before crossing the placenta.

Having MS should not influence the choice of delivery method; however, significant disability (such as spasticity) should be taken into account.

MRI is not contraindicated in pregnancy, but the use of contrast dye should be avoided if possible. Routine scans can be deferred until after pregnancy.