Post-partum relapse in women with multiple sclerosis after neuraxial labour analgesia or neuraxial anaesthesia: A multicentre retrospective cohort study

被引：5

作者：

Bouvet, Lionel ^{[1
,2
]}

Fontana, Margaux ^{[1
]}

Bouthors, Anne-Sophie ^{[3
]}

Bonnin, Martine ^{[4
]}

Storme, Brigitte ^{[4
]}

Bayoumeu, Francoise ^{[5
]}

Corsia, Gerard ^{[6
]}

Vukusic, Sandra ^{[7
,8
,9
,10
]}

Chassard, Dominique ^{[1
,2
]}

机构：

[1] Hosp Civils Lyon, Hop Femme Mere Enfant, Dept Anaesthesiol & Intens Care, Lyon, France

[2] Claude Bernard Lyon 1 Univ, Univ Lyon, APCSe VetAgro Sup UPSP 2016 A101, Lyon, France

[3] CHU Lille, Maternite Jeanne Flandre, Dept Anaesthesiol & Intens Care, Lille, France

[4] CHU Clermont Ferrand, Hop Estaing, Dept Anaesthesiol & Intens Care, Clermont Ferrand, France

[5] CHU Toulouse, Hop Paul de Viguier, Dept Anaesthesiol & Intens Care, Toulouse, France

[6] Hop La Pitie Salpetriere, AP HP, Dept Anaesthesiol & Intens Care, Paris, France

[7] Hosp Civils Lyon, Hop Neurol Pierre Wertheimer, Dept Neurol, F-69677 Lyon, France

[8] INSERM 1028, Ctr Neurosci Lyon, F-69003 Lyon, France

[9] CNRS UMR5292, F-69003 Lyon, France

[10] Univ Lyon, F-69003 Lyon, France

来源：

ANAESTHESIA CRITICAL CARE & PAIN MEDICINE | 2021年 / 40卷 / 05期

关键词：

Multiple sclerosis; Pregnancy; Post-partum; Relapses; Neuraxial anaesthesia; Neuraxial analgesia; LIDOCAINE; TOXICITY; EVENTS; FRANCE;

D O I：

10.1016/j.accpm.2021.100834

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Background: The proportion of women with multiple sclerosis experiencing a relapse in the post-partum period after neuraxial labour analgesia or neuraxial anaesthesia remains uncertain. This study aimed to assess the association between neuraxial labour analgesia or neuraxial anaesthesia and the occurrence of relapse during the first three months post-partum. Methods: In this retrospective cohort study, cases of women with a diagnosis of multiple sclerosis delivering between January 2010 and April 2015 were analysed. Demographic, anaesthetic and obstetric characteristics, occurrence and number of relapses in the year preceding pregnancy, during pregnancy, and the first three post-partum months, were recorded. Logistic regression analyses were performed for the identification of factors associated with the occurrence of post-partum relapse. Results: A total of 118 deliveries in 104 parturients were included, these were 78 (66%) vaginal deliveries and 40 (34%) caesarean deliveries. Neuraxial analgesia was provided in 50 deliveries, and neuraxial anaesthesia in 46 deliveries; no neuraxial anaesthesia or analgesia was administered in remaining 22 deliveries. Post-partum relapse occurred in 31 women (26%). There was no association between obstetric or anaesthetic characteristics and post-partum relapse. Both the occurrence and number of relapses prior to and during pregnancy, and the time between last relapse and delivery, were significantly associated with post-partum relapse in univariate analysis. The occurrence of relapse within the year preceding the pregnancy was the sole independent factor associated with post-partum relapse. Conclusion: Neuraxial procedures were not associated with increased rate of post-partum relapse; only disease activity prior to pregnancy was predictive of post-partum relapse. (C) 2021 Societe francaise d'anesthesie et de reanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

引用

页数：7

共 33 条

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