Papers of the Week

"Pregnancy and multiple sclerosis Pregnancy is a possibility for a patient with multiple sclerosis, but it is best to anticipate and plan for it. Pregnancy does not worsen the disability in the long term. The risk of relapse in the 3 months postpartum depends on the risk of relapse in the year preceding the pregnancy; it is therefore preferable to plan a pregnan¬cy when the multiple sclerosis is stabilized. The main¬tenance of background treatment in preconception or during pregnancy depends on the type of medication, the risk for the child (miscarriage, malformations) but also the risk of rebound in the mother. Pregnancy fol-low-up and mode of delivery are comparable to those of the general population. Epidural analgesia is not contraindicated. The decision to breastfeed must take into account the patient's wishes and the severity of the disease (contraindication of breastfeeding with certain background treatments). There is no validated preventive treatment for postpartum relapses."