Batista Sónia, Silva Ana Martins, Sá Maria José, Sousa Lívia, De Sá João, Pedrosa Rui, Cerqueira João, Pinheiro Joaquim, Abreu Pedro, Simões Rita Moiron, Dias Elsa, Veríssimo Carlos, Vale José
Serviço de Neurologia. Centro Hospitalar e Universitário de Coimbra. Coimbra; Faculdade de Medicina. Universidade de Coimbra. Coimbra. Portugal.
Serviço de Neurologia. Centro Hospitalar do Porto. Porto. Instituto de Ciências Biomédicas Abel Salazar. Universidade do Porto. Porto. Portugal.
Acta Med Port. 2018 Dec 28;31(12):785-795. doi: 10.20344/amp.10752.
Multiple sclerosis typically affects young women of reproductive age. Therefore, all healthcare providers involved in the follow-up of multiple sclerosis patients must be prepared to discuss pregnancy and breastfeeding issues, and provide the best possible counselling. However, there are still many doubts and heterogeneous clinical approaches partly due to the lack of consensus and guidelines. Concerning the handling of disease modifying therapies during pregnancy and the postpartum period, uncertainties have been complicated by the increase in recent years of the number of available treatments. This article aims to present the state-of-the-art and provide guidance based on the best level of available evidence and expert opinion regarding the management of multiple sclerosis patients at different stages: pregnancy planning, pregnancy, partum, and the postpartum period.
多发性硬化症通常影响育龄期年轻女性。因此,所有参与多发性硬化症患者随访的医疗保健提供者都必须准备好讨论妊娠和母乳喂养问题,并提供尽可能最佳的咨询服务。然而,部分由于缺乏共识和指南,仍然存在许多疑问和不同的临床处理方法。关于孕期和产后疾病修正治疗的处理,近年来可用治疗方法数量的增加使不确定性变得更加复杂。本文旨在介绍最新情况,并根据现有最佳证据水平和专家意见,为不同阶段(妊娠计划、孕期、分娩期和产后期)的多发性硬化症患者管理提供指导。