ArticleJA clinical reports2025
Epidural labor analgesia in a pregnant woman with symptomatic recurrence of myelin oligodendrocyte glycoprotein antibody-associated disease: a case report.
Article in JA clinical reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMyelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a demyelinating disorder that may relapse during pregnancy. The safety of neuraxial anesthesia in such patients remains unclear. CASE PRESENTATION: We describe a 32-year-old multiparous woman with MOGAD who developed intractable hiccups due to new medullary lesions at 35 weeks of gestation. Despite steroid pulse therapy, symptoms persisted. At 36 weeks and 2 days, premature rupture of membranes occurred, and hiccups worsened with labor pain. After informed consent, labor epidural analgesia was initiated using low-concentration levobupivacaine with minimal fentanyl. Pain relief coincided with the reduction of hiccups. Vaginal delivery of a male infant was uneventful. Her hiccups resolved by postpartum day 4, and magnetic resonance imaging showed improvement in the lesion. She was discharged on postpartum day 7 without neurological worsening.
conclusionsLabor epidural analgesia provided effective pain control and was associated with symptom relief in a parturient with active MOGAD.
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