MS Relapse During Pregnancy: Can It Happen to You?

Ask your doctor what medications are best, just in case
Dion and family

MS has taken a back seat in Dion W’s life since she’s been pregnant. But she knows that could change.

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And she knows all too well what to watch for when it comes to her multiple sclerosis attacks.

Numbness. Loss of vision. Fatigue that comes and goes.

Changes in weather also often are a trigger. “Something about me and the weather, we don’t get along,” says the 35-year-old Northeast Ohio resident.

A protected time

Dion has been free from flare-ups since she got pregnant, despite dropping her medications.

That’s because pregnancy is a protected time for most MS patients, thanks to hormonal and immune system shifts.

For that reason, relapses usually aren’t considered a major concern for pregnant women with MS, says neurologist Mary R. Rensel, MD.

“We see more relapses postpartum — the first 9 months after the baby is born — most likely because the immune system and hormones are returning to normal and the mother is up late with the baby,” Dr. Rensel says. “There is a 20 to 40 percent chance of a new symptom after the baby comes.”

Relapse red flags

During pregnancy, though, women just need to keep an eye out for possible problems. Signs that an exacerbation — another word for relapse — is occurring include:

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  • Severe fatigue.
  • New visual symptoms.
  • Numbness.
  • Tingling.
  • Poor balance or weakness.
  • Trouble walking.

“If any of these symptoms bother their daily ability to function or last two days, they should call their primary care physician or their neurologist,” Dr. Rensel says.

To be a true exacerbation, the attack must last a full day and be separated from the previous bout by at least 30 days, according to the National Multiple Sclerosis Society. Most relapses last from a few days to several weeks or even months, and vary from person to person.

“One study suggests that spinal anesthesia (during labor) may increase new symptoms of MS, but it’s a small study,” says Dr. Rensel. “I recommend avoiding it. An epidural is OK.”

Dion is due to have her baby girl at Hillcrest Hospital in early June. She understands that some relapse risks come with delivery.

“My OB assured me that I will have enough estrogen in my body that it shouldn’t be a problem,” she says.

Treating a relapse

If an attack does arise during pregnancy, Dr. Rensel recommends a talk with your doctors. She says corticosteroids sometimes can be called on to treat MS symptoms while a woman is pregnant.

“We are able to use those during certain phases of the pregnancy,” she says. “Usually we don’t like to use them very early or very late in the pregnancy. We always work with the obstetrician and make sure it’s a safe time.”

Preparing for the arrival

Dion says relapses are a concern after the baby arrives.

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“You want to be the best for your child, and you don’t know, so my husband and I are both scared,” she says. “He has vocalized it. I kind of keep it to myself. He wants a well wife first.”

Having friends and family lined up to help when hormones are crashing – at least for the first six weeks – is key, Dr. Rensel says.

That way support is there when you need it – even if your MS comes back into the picture.


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