title: Two consecutive pregnancies in early and late stage of amyotrophic lateral sclerosis.
abstract: There are few reports on pregnancies in sporadic and familial amyotrophic lateral sclerosis (ALS). We report on a young woman with sporadic ALS who gave birth twice during the course of her disease. The first pregnancy occurred 13 months after the onset of symptoms, and one month after diagnosis. The pregnancy was uncomplicated and resulted in vaginal delivery of a healthy boy. Fifteen months later, when she was already bed-ridden, she became pregnant again. She received a percutaneous endoscopic gastrostomy in the 21st gestational week and underwent early Caesarean section in the 34th week of gestation. The child was ventilated for 72 h in a neonatological unit. The patient was tracheotomized and ventilated two months later, i.e. 47 months after symptom onset, and died nine months later from gastrointestinal haemorrhage. Her two children have developed without abnormalities to date. This case confirms that pregnancies in early-stage ALS can develop normally and may result in uncomplicated vaginal delivery. Pregnancies in late stages may be critical for mother and child, and early delivery by Caesarean section may become necessary although neonatal outcome can be good.
authors.affiliation: Clinic of General Neurology, Medical University Sofia, University Hospital Alexandrovska, Sofia, Bulgaria.
authors.forename: Stayko
authors.initials: S
authors.lastname: Sarafov
authors.forename: Maryana
authors.initials: M
authors.lastname: Doitchinova
authors.forename: Zhvka
authors.initials: Z
authors.lastname: Karagiozova
authors.forename: Boriana
authors.initials: B
authors.lastname: Slancheva
authors.forename: Reinhard
authors.initials: R
authors.lastname: Dengler
authors.forename: Susanne
authors.initials: S
authors.lastname: Petri
authors.forename: Katja
authors.initials: K
authors.lastname: Kollewe
mesh_terms: D000328:Adult; D000690:Amyotrophic Lateral Sclerosis / Q000503:physiopathology*; D002585:Cesarean Section; D036861:Delivery, Obstetric; D017809:Fatal Outcome; D005260:Female; D005865:Gestational Age; D006801:Humans; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome