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Family planning, antenatal and post partum care in multiple sclerosis: a review and update
Author(s) -
Van Der Walt Anneke,
Nguyen AiLan,
Jokubaitis Vilija
Publication year - 2019
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/mja2.50113
Subject(s) - breastfeeding , fertility , medicine , multiple sclerosis , pregnancy , disease , multidisciplinary approach , family planning , post partum , family medicine , clinical practice , intensive care medicine , nursing , population , pediatrics , psychiatry , environmental health , social science , pathology , sociology , biology , research methodology , genetics
Summary Multiple sclerosis is more prevalent in women of childbearing age than in any other group. As a result, the impact of multiple sclerosis and its treatment on fertility, planned and unplanned pregnancies, post partum care and breastfeeding presents unique challenges that need to be addressed in everyday clinical practice. Given the increasing number of disease‐modifying agents now available in Australia for the treatment of multiple sclerosis, there is a growing need for clinicians to provide their patients with appropriate counselling on family planning. Providing better evidence regarding the relative risks and benefits of continuing therapy before, during and after pregnancy is an important research priority. International pregnancy registries are essential in developing better evidence‐based practice guidelines, and neurologists should be encouraged to contribute to these when possible. The management of women with multiple sclerosis, especially when they are taking disease‐modifying agents, requires careful assessment of fertility and disease characteristics as well as a multidisciplinary approach to ensure positive outcomes in both mothers and their children.