PMC:4187331 / 22068-23246 JSONTXT

{"project":"NEUROSES","denotations":[{"id":"T333","span":{"begin":155,"end":163},"obj":"PATO_0000434"},{"id":"T334","span":{"begin":404,"end":410},"obj":"PATO_0001309"},{"id":"T335","span":{"begin":429,"end":433},"obj":"CHEBI_23888"},{"id":"T336","span":{"begin":516,"end":522},"obj":"PATO_0002354"},{"id":"T337","span":{"begin":781,"end":787},"obj":"PATO_0002354"},{"id":"T338","span":{"begin":562,"end":567},"obj":"PATO_0000569"},{"id":"T339","span":{"begin":562,"end":567},"obj":"PATO_0000574"},{"id":"T340","span":{"begin":578,"end":596},"obj":"CHEBI_6888"},{"id":"T341","span":{"begin":1033,"end":1037},"obj":"PATO_0001323"}],"text":"Conclusion\nOverall, pregnancy not only has not harmful effect on MS course, but it also seems to be beneficial. Nonetheless, physicians should be aware of maternal and fetal concerns in MS disease and manage every patient with considering her/his especial condition. There is general consensus that because of probable fetal side effects, DMDs be discontinued before conception with considering a window period (based on type of drug). However, GA appears to be a reasonable option during pregnancy in patients with active disease. Relapse can be treated with a short course of methylprednisolone pulse or IVIG (in intractable attacks). Likewise, IVIG is recommended by some experts as a disease modifying agent in postpartum immediately after delivery especially in patients with active disease. All DMDs are contraindicated in lactation. Thereupon, breastfeeding should be discontinued if DMDs are mandatory to be started. At the end, recognizing the precise mechanism of pregnancy-induced immunomodulation in MS as an interesting area for future investigations could provide insight into better understanding of disease pathogenesis and designing novel therapeutic strategies"}