A client with a history of relapsing-remitting multiple sclerosis is expecting her first child. Which of the following would be indicated for this client?

Question

1. Instruct to expect an exacerbation of symptoms while pregnant
2. Discuss pain control during labor since contractions will be severe
3. Suggest reproductive counseling since multiple sclerosis is genetic
4. Instruct to expect a period of remission after delivery of the baby

Answer 1

3. Suggest reproductive counseling since multiple sclerosis is genetic

Rationale:
Since there is increased evidence of a genetic predisposition for multiple sclerosis, reproductive counseling is recommended. Pregnancy often brings about remission of multiple sclerosis, but with a slightly increased relapse rate postpartum. The strength of uterine contractions in a client with multiple sclerosis is not severe, and because clients often have lessened sensation, labor may be almost painless.