Pregnancy in multiple sclerosis: A reflection on the importance of individualizing management

Abstract

Introduction The management of multiple sclerosis during pregnancy has changed in recent years; it is no longer viewed as hindering the evolution of the disease. Lower relapse rates are expected during gestation, while the early puerperium may be more critical. Case report We present two cases of active relapse‐remitting multiple sclerosis in pregnant women with different clinical courses, mirroring the disease heterogeneity and unpredictability. The first one, despite the ongoing activity, had two uneventful pregnancies. The second woman, previously controlled, experienced an increase in the disease activity during pregnancy. Discussions The decision of maintaining disease‐modifying therapy throughout gestation could be a strategy to reduce postpartum relapses.