A #practical topic for today. #Pregnancy changes things - but more so for our #neurology patients - or not? #pearls from the #EAN2020 #MedEd #MedTwitter #MedStudentTwitter #neurologyresident @EANeurology @WNGtweets
Let’s first address #multiplesclerosis. Patients get better in third trimester and 30% relapse #postpartum. Immune responses shifts to anti-inflammatory in 3rd trimester to accommodate fetus - #etcomehome - but rebounds after birth. #MedEd #doubledoc #AcademicTwitter
Continue #firstlineinjectables #glatiramer and #interferon - these don’t cause #teratogenicity. In flares, consider IVIG and PLEX. How about #steroids? Usually fine except in 1st trimester when they can cause birth defects #MedEd #MedStudentTwitter #MedTwitter
All pregnancies should be planned for #MultipleSclerosis patients because high postpartum flare rate is aggravated by poor control in preceding year. What about unplanned #pregnancies? #MedTwitter #MedStudentTwitter #MedEd
#multiplesclerosis patients on #firstlineinjectables should continue - and those on #natalizumab because the risk of relapse on discontinuation is high. More thoughts? @NinaRiggins @WNGtweets @MadSattinJ @DxRxEdu @massneuro @WomenNeurology @EricLawson90 @AlexMuccilli #MedTwitter
@threadreaderapp pls unroll
