- Foreword
- Contributors
- 1 General Approach to Pregnancy Care in the Neurologic Patient
- 2 Pregnancy Safety and Termination
- 3 Contraception Options in Neurologic Disease
- 4 Pregnancy Physiology
- 5 Fetal Imaging for the Neurologist
- 6 Prenatal Genetics for Women with Neurology Disease
- 7 Radiation Exposure and Neuroimaging During Pregnancy
- 8 Cognitive Changes in Pregnancy
- 9 Principles of Reproductive Healthcare in Chronic Neurologic Disease
- 10 Immune-mediated Disorders of the Central Nervous System
- 11 Neurologic Infections in Pregnancy
- 12 Headache
- 13 Traumatic Brain Injury and Pregnancy
- 14 Ischemic Stroke Management in Pregnancy
- 15 Hemorrhagic Stroke Management in Pregnancy
- 16 Management of Intracranial Vascular Lesions During Pregnancy
- 17 Cerebral Venous Thrombosis
- 18 Brain Tumors in Pregnancy
- 19 Movement Disorders in Pregnancy
- 20 Pregnancy and Epilepsy
- 21 Seizure Medications Effects on Fetus, Neonate, and Lactation
- 22 Postpartum Care for Women with Epilepsy
- 23 Sleep Disorders and Pregnancy
- 24 Neuromuscular Diseases
- 25 Charcot-Marie-Tooth Disease and Pregnancy
- 26 Guillain-Barré Syndrome and Chronic Inflammatory Demyelinating Polyradiculoneuropathy in Pregnancy
- 27 Entrapment Neuropathy and Pregnancy
- 28 Neurocutaneous Disorders in Pregnancy
- 29 Spinal Cord Injury in Pregnancy
- 30 Inherited Metabolic Diseases (IMDs) and Pregnancy
- 31 Approach to Delivery in the Patient with Neurologic Disease
- 32 Anesthetic Considerations for Neurologic Patients
- 33 Neurologic Complications in Obstetric Anesthesia
- 34 Perinatal Depression in Neurological Disease and Disability
- 35 Breastfeeding in the Context of Neurological Disorders
- Index
(p. 81) Immune-mediated Disorders of the Central Nervous System
- Chapter:
- (p. 81) Immune-mediated Disorders of the Central Nervous System
- Author(s):
Patricia K. Coyle
- DOI:
- 10.1093/med/9780190667351.003.0010
This chapter reviews pregnancy in multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and acute transverse myelitis (ATM) syndrome. MS is a major acquired disease of young adults, with a rising female predominance. MS has no direct negative consequences on fertility or pregnancy. Pregnancy has a profound effect on MS, with decrease in disease activity during the last trimester counteracted by a three-month postpartum increase in disease activity. With the development of disease-modifying therapies, important questions arise about washout periods, the feasibility and risks of treating during pregnancy and breastfeeding, and the potential of treatment-related adverse fetal effects. Fortunately, there is good information to counsel women with MS. Neuromyelitis Optica Spectrum Disorder (NMOSD) is a neuroimmune channelopathy. It is a distinct disorder from MS. NMOSD disease activity is not favorably affected by pregnancy. The postpartum period has real risk for disabling attacks. This influences recommendations about breastfeeding and how quickly to resume therapy postpartum. Acute transverse myelitis (ATM) syndrome can occur in both MS and NMOSD but can also be due to other disorders. Workup and treatment of ATM during pregnancy is reviewed, as well as implications for delivery.
Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.
Please subscribe or login to access full text content.
If you have purchased a print title that contains an access token, please see the token for information about how to register your code.
For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.
- Foreword
- Contributors
- 1 General Approach to Pregnancy Care in the Neurologic Patient
- 2 Pregnancy Safety and Termination
- 3 Contraception Options in Neurologic Disease
- 4 Pregnancy Physiology
- 5 Fetal Imaging for the Neurologist
- 6 Prenatal Genetics for Women with Neurology Disease
- 7 Radiation Exposure and Neuroimaging During Pregnancy
- 8 Cognitive Changes in Pregnancy
- 9 Principles of Reproductive Healthcare in Chronic Neurologic Disease
- 10 Immune-mediated Disorders of the Central Nervous System
- 11 Neurologic Infections in Pregnancy
- 12 Headache
- 13 Traumatic Brain Injury and Pregnancy
- 14 Ischemic Stroke Management in Pregnancy
- 15 Hemorrhagic Stroke Management in Pregnancy
- 16 Management of Intracranial Vascular Lesions During Pregnancy
- 17 Cerebral Venous Thrombosis
- 18 Brain Tumors in Pregnancy
- 19 Movement Disorders in Pregnancy
- 20 Pregnancy and Epilepsy
- 21 Seizure Medications Effects on Fetus, Neonate, and Lactation
- 22 Postpartum Care for Women with Epilepsy
- 23 Sleep Disorders and Pregnancy
- 24 Neuromuscular Diseases
- 25 Charcot-Marie-Tooth Disease and Pregnancy
- 26 Guillain-Barré Syndrome and Chronic Inflammatory Demyelinating Polyradiculoneuropathy in Pregnancy
- 27 Entrapment Neuropathy and Pregnancy
- 28 Neurocutaneous Disorders in Pregnancy
- 29 Spinal Cord Injury in Pregnancy
- 30 Inherited Metabolic Diseases (IMDs) and Pregnancy
- 31 Approach to Delivery in the Patient with Neurologic Disease
- 32 Anesthetic Considerations for Neurologic Patients
- 33 Neurologic Complications in Obstetric Anesthesia
- 34 Perinatal Depression in Neurological Disease and Disability
- 35 Breastfeeding in the Context of Neurological Disorders
- Index