Multiple Sclerosis in Pregnancy– Variations and Challenges

Dr Nudrat Farooq

Dr Mais Ibrahim

Dr Selva kumari

Department of Obstetrics and Gynaecology, NMC Royal Hospital, Sharjah

INTRODUCTION/BACKGROUND Multiple sclerosis (MS) is a common autoimmune disease in women of

reproductive age. Pregnancy often reduces relapse risk, but relapses may

increase postpartum. Managing MS during pregnancy, especially with

ongoing treatment, is challenging. We present cases of relapse during

pregnancy and puerperium with their management.

CASES

Case A:

26-year-old woman with MS diagnosed at 21, initially

treated with dimethyl fumarate, fingolimod, and later

ocrelizumab. First pregnancy ended in elective LSCS

with good outcome. In current pregnancy, she stopped

treatment at 37 weeks developed visual symptoms.

Treated with steroids and delivered via repeat cesarean

without complications.

Case B:

28-year-old woman with MS previously on interferon.

First pregnancy was uneventful; postpartum relapse

treated with interferon. Second pregnancy was stable

until emergency cesarean for chorioamnionitis. Post-op

relapse with back pain and weakness; interferon

therapy restarted.

OBJECTIVES/AIMS

To present case-based experiences of MS relapse during pregnancy

and puerperium, and highlight management approaches with a focus

on medication safety, maternal outcomes, and fetal wellbeing.

METHODS

We present two clinical cases of pregnant women with pre-existing MS who

experienced relapses during late pregnancy and postpartum. Their obstetric

and neurologic management, including use of corticosteroids and interferon

therapy, are discussed in collaboration with neurologists and obstetricians.

CONCLUSIONS

Pregnancy in women with MS is not inherently high-risk but

requires individualized care. Close monitoring, timely

intervention, and coordination between neurologists and

obstetricians are essential. Relapses post-delivery often

reflect disease activity prior to pregnancy. Steroids and

interferon can be safely used in selected cases.

REFERENCES

Buron MD et al., Neurology. 2020;95(8):e1041-e1051

Buraga I, Popovici RE. Sci World J 2014

Airas L, Kaaja R. Obstet Med. 2012

Finkelsztejn A. Perspect Medicin Chem. 2014

CONTACT INFORMATION

Email : nudrat.farooq@nmc.ae

Phone: 00971 50 297 9053

@rcobsgyn #RCOG2025