Sarafov Stayko, Doitchinova Maryana, Karagiozova Zhvka, Slancheva Boriana, Dengler Reinhard, Petri Susanne, Kollewe Katja
Clinic of General Neurology, Medical University Sofia, University Hospital Alexandrovska, Sofia, Bulgaria.
Amyotroph Lateral Scler. 2009 Oct-Dec;10(5-6):483-6. doi: 10.3109/17482960802578365.
There are few reports on pregnancies in sporadic and familial amyotrophic lateral sclerosis (ALS). We report on a young woman with sporadic ALS who gave birth twice during the course of her disease. The first pregnancy occurred 13 months after the onset of symptoms, and one month after diagnosis. The pregnancy was uncomplicated and resulted in vaginal delivery of a healthy boy. Fifteen months later, when she was already bed-ridden, she became pregnant again. She received a percutaneous endoscopic gastrostomy in the 21st gestational week and underwent early Caesarean section in the 34th week of gestation. The child was ventilated for 72 h in a neonatological unit. The patient was tracheotomized and ventilated two months later, i.e. 47 months after symptom onset, and died nine months later from gastrointestinal haemorrhage. Her two children have developed without abnormalities to date. This case confirms that pregnancies in early-stage ALS can develop normally and may result in uncomplicated vaginal delivery. Pregnancies in late stages may be critical for mother and child, and early delivery by Caesarean section may become necessary although neonatal outcome can be good.
关于散发性和家族性肌萎缩侧索硬化症（ALS）患者怀孕的报道较少。我们报告了一名患有散发性ALS的年轻女性，她在患病期间分娩了两次。首次怀孕发生在症状出现后13个月，诊断后1个月。此次怀孕无并发症，通过阴道分娩出一个健康男婴。15个月后，当她已经卧床不起时，再次怀孕。她在孕21周时接受了经皮内镜下胃造口术，并在孕34周时接受了早期剖宫产。孩子在新生儿科接受了72小时的通气治疗。患者在两个月后，即症状出现47个月后接受了气管切开并通气，九个月后死于胃肠道出血。她的两个孩子至今发育正常。该病例证实，早期ALS患者的怀孕可以正常进展，并可能导致无并发症的阴道分娩。晚期怀孕对母婴可能至关重要，尽管新生儿结局可能良好，但剖宫产早期分娩可能成为必要。
