Pregnancy in patients with neuromyelitis optica – literature review and own experience Case report
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Abstract
Neuromyelitis optica and neuromyelitis optica spectrum disorders is a group of rare demyelinating disorders of the central nervous system of autoimmune etiology. As the disease is mainly confirmed in the female gender (ca. 2 : 1 to 9 : 1), as well as the fact that the average age of the diagnosis correlating to procreative period in women, the influence of the pregnancy on Devic disease course is now widely discussed in the literature.
The purpose of our study was to assess the pregnancy course in patients with NMO and the influence of pregnancy on the course of the disease, both during pregnancy and after the termination. The study was based on review the most recent data from literature and personal experience in the management of patients who are under the care of the Department of Neurology Medical University of Warsaw and the out-patient Clinic of Demyelinating Diseases.
According to data from literature and personal experience the pregnancy in most cases adversely affected the course of Devic disease resulting in increasing the relapse rate as well as disability progression. The pregnancy course is more severe in patients with the presence of antibodies to aquaporin-4. It is associated with its impact on inflammatory process within the placenta and can result in placental damage and fetal death. It is also important if the patient was properly treated before and during the pregnancy. It can significantly reduce the risk of disease relapse.
Procreative plans of childbearing age should be discussed with the patients in order to plan their therapies both before and during pregnancy and in the postpartum period.
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