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Best Practice

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Document Typology: Training course
Target groups: Patients
country Where It Took Place: Lithuania
Name of compiler: Aldona Droseikiene
name of institution: Lithuania multiple sclerosis union
role: Project Meneger
language Of The Description: English
title: Pregnancy and multiple sclerosis
description Of The Best Practice:
There is no reason to believe that pregnancy can lead to negative long-term effects of MS ,conversely for the woman who is waiting for a baby ,the episodic attacks attacks dropped by 50 percent.
Of course, sometimes after childbirth, women experience additional psychological and physical stress because it is a normal reaction to hormonal changes during pregnancy.
The realationship between MS and pregnancy has been studied in a number of retrospective and prospective studies. A recent European multicentral study PRIMS , involving 254 pregnant women with MS ,comfirmed the influance of pregnancy to clinical course of MS
Results:
The results showed that the overall impact of pregnancy to MS relapse rate was neutral.Protection against MS relapses in late pregnancy could be axplained by the shift of maternal immunity from proinflammatory TH1 to antiinflammatory TH2.Oral contraceptives,breast feeding,epidural analgesia do not have any adverse effect on MS ralapse rate or progression of dissability.
Quality indicators:
Use of methodologies in order to involve the citizens in the field of training and education health system
Comment:
For many women with multiple sclerosis, the diagnosis comes right at the time when they are thinking of starting (or expanding) their family. Years ago, women with MS were discouraged from having children, as doctors believed that pregnancy made MS worse and that they would not be able to care for young children. The picture is much brighter today.,because these rezultes showed that women with MS should not be discouraged from becoming pregnant.

Evaluation:
Studies show that MS doesn’t appear to increase the risk of problems that can occur during any pregnancy.
The findings have implications for the treatment and follow-up of pregnant women with MS. To prevent postpartum relapses, disease-modifying treatment should be initiated as early as possible.
Of course it is important to talk to doctor beforehan before planning to get pregnant.
Lack of knowledge has led to several cases of induced abortions of normal fetuses and still creates a high degree of anxiety and insecurity among women with MS and their relatives, as well as among obstetricians and neurologists caring for these patients
These studies also show that anesthesia is not any more risky for women who have MS than other women during labor MS is not directly inherited like some genetic diseases, like cystic fibrosis. The evidence shows that there is about a 2% chance of a child born to a parent with MS developing MS themselves. There are currently no genetic or prenatal tests, or even tests on your newborn, that can determine the likelihood of this happening.

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