Twenty-eight year old, G1P1001, Caucasian female presents for six week postpartum appointment. She is active duty and part of a dual military couple. She is also active in basketball, running and enjoys most physical fitness activities. One day while playing basketball (prior to knowing she was pregnant) she fell and hit her head and suffered a brief loss of consciousness. She was taken to the emergency room and an MRI was done. The MRI revealed lesions consistent with Multiple Sclerosis. Her and her husband had been trying to conceive and she found out she was pregnant two weeks after the MRI. Her brother has Duchenne Muscular Dystrophy and she is also a carrier. Husband has no familial genetic history and is not a carrier for Muscular Dystrophy. Her prenatal course was unremarkable and she had an uneventful SVD. She was currently breastfeeding at the postpartum appointment but stated she has to stop now and start back on Interferon. While off the Interferon during pregnancy she remained symptom free. Her depression scale was an 8 but she was very open about her disease and does her best to not let her disease bring her down. She was very proud to share she took her Navy PRT 7 days after delivery. I ask about hindsight regarding the signs of Multiple Sclerosis and she said many but the most obvious sign is that she has been clumsy her whole life. She reports no muscle, bowel, bladder, eye, or neurological symptoms. Her postpartum physical assessment unremarkable. She states she will be able to remain on active duty as long as her disease allows. It’s amazing that a person with a debilitating disease can get pregnant, have an uncomplicated pregnancy and unremarkable delivery.
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