b'Medicine & Research1992-1995,andPreventionofPost-Partum Formanypeople,havingchildrenisanRelapseswithProgestinandEstradiolin importantpartoftheirlifegoals.AnMSMultipleSclerosis(POPARTMUS),conducted diagnosisshouldnottakethatdreamaway.from2005-2012.Researchersfoundthatof With appropriate planning, most womenthe389womenwhoparticipatedinthisstudy withMSshouldbeabletohaveanuneventfulthattheriskofpost-partumrelapsesstrongly pregnancyandpostpartumexperience.correlatedwithrecentdiseaseactivity,but Study nds more optionsnot with performing neuraxial analgesia. in use of oral methylprednisoloneThestudyacknowledgedthattherearesomepotentialrisksbutthereislimitedevidence Researchersinmultiplelocationsthrough-togiveguidanceonewayoranother. out Spain,andledbyresearchersattheThisstudywaspublishedintheMultiple HospitalGermansTrias-i-PujolNeuroscienceSclerosis Journal. Department,inBadalona,Spain,soughttodetermine if clinical and radiologicalDr. Thrower: MSfrequentlyaectswomenof eectivenessremainedbetweentwodierentchildbearingageandtherefore,issuesregarding dosesoforalmethylprednisolone.CurrentpregnancyandMSareofgreatinterest. guidelinesrecommendoralmethylprednisoloneNeuraxialanalgesiareferstopainrelief atadoseof500mgormoreperdayforvethroughanepiduralblock,spinalblock,or daysorintravenousmethylprednisoloneatsomecombinationofthetwo.Manywomen 1000mgperdayforthreetovedays.InthewithMSquestionwhethertheycansafely pilotstudy,patientsreceivedeither1250orhavethistypeofprocedureduringlaborand 625mgoforalmethylprednisolone.Thegoaldelivery.TheanswerisYes. wastodeterminewhetheralesserhigh-doseNeuraxialanalgesiasuchasanepidural couldbeconsideredasatreatmentoption.has traditionally been considered safe for TheeectontheExpandedDisabilityStatuswomenwith MS and this study provides Scalescoredecreasesat90daysweresimilarfurtherevidenceofthat.Anotherimportant andafter30daystherewerenodierenceinndingfromthisstudywasthat25percent neworenlargedT2lesionsonMRIoutcomes.ofwomenwith MS experienced a relapse Additionally,therewasnodierenceinqualitywithinthreemonthsofdelivery.Thismeans oflifeondaysevenor30.Thisresearch75percentofwomenhadanuneventful contributestotheoptionsthatarepossiblewithdosingoforalmethylprednisolone,butpostpartumexperience.Otherstudieshave adverseeventsonanindividualbasisneedtosuggestedthatasignicantpredictorofthe beconsideredsincetherewerefewparticipantsriskofpostpartumrelapsesiswhetherthe inthisstudy.womansMSwasstablepriortothepregnancy. ThisstudywaspublishedintheEuropeanInotherwords,womenwhoarehaving Journal of Neurology.relapsesand/ornewlesionsonMRIpriortopregnancy,maybeathigherriskforhaving Dr. Thrower: Relapsesareanunfortunatearelapseinthemonthsafterdelivery. realityforsomewithMS.Theresultingmsfocusmagazine.org 54'