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How can a multiple sclerosis (MS) relapse after childbirth be prevented?

Postpartum administration of intravenous (IV) steroids significantly reduced the incidence of relapses in women with multiple sclerosis (MS) in a study conducted at the Baylor College of Medicine in Houston, Texas. Of the 52 women in the study, 39 received postpartum IV steroids (methylprednisolone, 1 g), and 13 did not. During the first postpartum trimester,18 percent of women who received IV steroids experienced relapses. The frequency of relapse was about 46 percent in those who did not receive steroids. In the second and third postpartum trimesters, relapse percentage was about 26 percent among patients who received steroids and 23 percent in those who did not.

The retrospective analysis included 50 women with relapsing-remitting MS and two with secondary progressive MS who had experienced one or more pregnancies. Examined data included MS type; number of relapses before, during, and after pregnancy (first, second, and third trimester postpartum); treatment history; breastfeeding duration; and postpartum IV steroid use. Seven patients had at least one relapse during pregnancy.

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