Wuebbolt Danielle, Nguyen Vanessa, D'Souza Rohan, Wyne Ahraaz
Division of Maternal and Fetal Medicine, Department of Obstetrics & Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, Canada.
Department of Medicine, Royal College of Surgeons in Ireland, Royal College of Surgeons in Ireland, Dublin, Ireland.
Obstet Med. 2018 Dec;11(4):171-177. doi: 10.1177/1753495X18758868. Epub 2018 Apr 16.
Devic syndrome or neuromyelitis optica is an autoimmune neurological condition characterized by relapsing symptoms of optic neuritis and transverse myelitis. Women with neuromyelitis optica suffer from adverse pregnancy outcomes and high relapse rates during pregnancy and the postpartum period.
This case series describes 13 pregnancies in four women with neuromyelitis optica managed at a tertiary hospital in Toronto, Canada.
In most cases, neurologic symptoms either worsened or developed for the first time during pregnancy or the postpartum period, and often responded to a combination of steroids, immunosuppressant medications, plasma exchange and intravenous immunoglobulin. The 13 pregnancies resulted in two miscarriages, three preterm and eight term births. One fetus whose mother was on gabapentin, prednisone and spironolactone, had congenital malformations (aplastic lung and fused fingers).
Despite high frequency of relapses in pregnancy and the postpartum period, with multidisciplinary team management, outcomes for women with neuromyelitis optica are encouraging.
视神经脊髓炎谱系疾病或视神经脊髓炎是一种自身免疫性神经系统疾病，其特征为视神经炎和横贯性脊髓炎的复发性症状。患有视神经脊髓炎的女性在妊娠期间及产后会出现不良妊娠结局和高复发率。
本病例系列描述了在加拿大多伦多一家三级医院接受治疗的4名患有视神经脊髓炎的女性的13次妊娠情况。
在大多数情况下，神经症状在妊娠期间或产后首次加重或出现，且通常对类固醇、免疫抑制药物、血浆置换和静脉注射免疫球蛋白的联合治疗有反应。这13次妊娠导致2次流产、3次早产和8次足月分娩。一名母亲正在服用加巴喷丁、泼尼松和螺内酯的胎儿出现了先天性畸形（肺发育不全和手指融合）。
尽管妊娠期间及产后复发频率较高，但通过多学科团队管理，视神经脊髓炎女性患者的妊娠结局令人鼓舞。
