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I'm 22 weeks pregnant with my first child and I am having an MS relapse. This relapse started about a week ago and I saw my neuro on Thursday. He suggests that I wait a few days and call him next week. If my symptoms don't get better he suggested a course of solumedrol and/or gabapentin. I've been searching the internet for information on relapses during pregnancy and can't find anything. Every website says relapses are greatly reduced. Well that's great, but not helpful.

Anybody else had a relapse while pregnant? Any resources that I can turn to? Is solumedrol and gabapentin safe during pregnancy?

Any help would be greatly appreciated. I'm kinda freaking out because I can't find any info and I don't want to do anything to harm my baby.

Looking up Thomas Hale's Medications and Mother's Milk 1999 (8th edition):

Gabapentin has a pregnancy risk category C, meaning either no studies on animals or humans, or else it showed adverse effects in animals and there is no info for humans.

Solu-medrol (methlypredinisone) didn't have a pregnancy risk category listed. Prednisone is a category B, meaning either animal studies showed no risk, or else adverse effects in animals were not confirmed during tests on pregnant women.

I would google Thomas Hale (Phd not Md, he's a pharmacy PhD) and go to his current site for more info. Focused on breastfeeding, but you may be able to glean some pg info.

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Good luck with your decision.

Jen.

Thanks for your response. I will google Thomas Hale. I'm sure it will be helpful. If not now, then definately when my little one comes as I plan to breast feed.

I have an appointment with my mid wife tomorrow. If she gives me the okay I will do the course of solumedrol and skip the gabapentin. I figure the solumedrol/prednisone will help shorten the exacerbation or lessen its effects. Whereas the gabapentin is just treating the symptoms.

Again, thank you for the response. As you can imagine this has me somewhat distraught.

esj--Just this week I received the winter 2010 issue of Momentum, the magazine from the National MS Society. Its cover story, "MS and Starting a Family," deals with many of your questions. I encourage you to find a copy (perhaps from your local NMSS office); their website, http://www.nationalmssociety.org/multim ... index.aspx does not yet have the winter issue posted.

Although I do not agree with the premise that MS is an autoimmune disease (I think that in my case excess insulin initiates the MS cascade), and I found no improvement when taking the disease-modifying drugs, the article makes good points:

Page 26, "… none of the disease-modifying drugs, including Avonex, Betaseron, Rebif, Tysabri, and Copaxone, are approved for use during pregnancy. Though these drugs haven't been proven to increase birth defects or affect development in unborn babies, most doctors tell their patients to stop – not only during pregnancy but for several months before trying to conceive. Indeed, some animal studies have found a higher rate of miscarriage with the interferon-based MS drugs."

Page 27, "During pregnancy, the mother's body releases estrogen and other hormones that suppress her immune response so she doesn't reject the baby. This natural immunosuppressant effect puts MS into a very quiet state, especially during the third trimester."

esj-- Perhaps your current exacerbation would naturally improve in your third trimester.

Page 32, "The breastfeeding conundrum:… just as in pregnancy, doctors usually recommend staying off disease-modifying drugs while you breastfeed. (You can take steroids while nursing, however.) If you decide to stay off your med and breastfeed, there is some evidence that nursing might protect you. 'The protection afforded through breastfeeding can be as beneficial, or more so, than the immune-suppressant drugs,' said Elsie E Gulick, PhD, RN, FAAN, professor emeritus at the Rutgers University College of Nursing, Newark, N.J.

When she studied new mothers with MS, Dr. Gulick discovered that women who did not breastfeed were three times more likely to have relapses and mothers who breastfed during the first three months of their baby's life. In other research, 87% of women who didn't breastfeed had a relapse in the first two months after delivery, compared with only 36% of women who breastfed exclusively."


My best to you. By the way, I encourage you to line up all the help you can from family and friends, or even hire paid help, if you can afford it, when you and baby come home – not just in the first few weeks, but for up to a year. Help with childcare, housekeeping, meal preparation, and even emotional support are SO important!

Hi there,

I truly feel for you. My relapse started in the 2nd trimester and got progressively worse through the 3rd trimester and I've been feeling better ever since delivery. I believe that my very low blood pressure (70 over 30 for about 5 months) during the 2nd and 3rd terms exacerbated cerebral hypoperfusion and resulted in a further weakening of the blood brain barrier. I always felt a bit better after drinking a coffee. I wonder how your blood pressure is?

My daughter just had her 1st child Feb. 27. She too feared that impending relapse. She has been on a supplement treatment for the past 3+ years. She got really slack with her supplements and started a relapse about 6 mos. after Annie was born. She got back on supps which have always stopped her relapses. They stopped this one also.

I wish u the very best..."try" not to over-worry. Easy to say, I know but stress seems to make it much worse!