In a retrospective study the authors have analyzed the influence of pregnancy and 6-month postpartum period upon the changes in Expanded Disability Status Scale (EDSS) and on the frequency of attacks in a set of 47 patients suffering from multiple sclerosis (MS). According to clinical course, the patients were divided into two groups with remitting-relapsing (RR) and secondary progressive (SP) course, and assessed separately. In the group with RR course, relapses during pregnancy and post-partum were observed in 69.7 % of cases. Most of relapses (91.3 %) appeared during puerperium while the course during pregnancy was comparatively stable (8.7 % of relapses). Relapse rate during 24 months before pregnancy was 1.0 attacks/year in comparison with 0.6 attacks/year during 9 months of pregnancy and 6 months after delivery. No worsening was observed in the group with SP course during pregnancy while progression during 6-month period after delivery was found in 53.9 % of patiens (the average worsening of EDSS was 0.9 points). In 71.5 % of these cases, the course then stabilised and remitted into pre-delivery state.

        Key words: multiple sclerosis, pregnancy, relapse, EDSS, T lymphocytes, estrogen, progesterone