MS is the most common acquired neurologic disorder of young adults, with at
least 2.5 million individuals affected worldwide. There is a female preponderance of 3:1. This gender bias will become more pronounced, because MS is on the rise among young (reproductive age) women. It typically occurs between 20 to 40 years of age.
A 21 year old primigravida at 36+3 weeks of gestational age complaints of continuous pain in abdomen and dry cough without breathlessness since one day. She was a known case of multiple sclerosis. . At 26 weeks she consulted neurologist in St. Philomena??s hospital in view of progressive lower limb weakness since 2 weeks and walk with support and was advised to start injection methylprednisolone pulse therapy and she improved in few weeks. At 36+3 weeks on examination her BP was 130/90 mmHg in right arm in supine position, other vitals were normal. Bilateral basal crepts were present on chest auscultation and mild IUGR noted per abdomen. Her BP continued to be between 130/90 to 140/90 mmHg , urine albumin 2+ , PIH profile were normal, multidisciplinary approach was taken and she was started on tablet labetalol. Patient had imminent signs and symptoms hence decision for emergency LSCS taken. Patient threw GTCS with frothing from mouth While taking up for emergency caesarean section, injection MgSo4 loading dose given and continued as per Pritchard regimen, emergency caesarean done.
Multiple sclerosis is an idiopathic, chronic inflammatory disease of the central
nervous system characterised by multiple plaques of demyelination in the brain and
spinal cord. There are many possible causes of MS, including viruses, auto immune disorders, environmental factors and genetic factors.In MS, the immune system commonly attacks its own nervous tissue. Symptoms include muscle weakness in the extremities, difficulty with coordination, spasticity, fatigue, loss of sensation, seizure, speech impediments, bowel and bladder dysfunction.