Search IconSearch
January 16, 2024/Neurosciences/Podcast

Managing Neurological Disorders in Pregnancy (Podcast)

A discussion of special care considerations before, during and after pregnancy

Physiologic changes that occur during pregnancy can exacerbate symptoms of existing neurologic disorders and cause a host of acute neurologic issues.


Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

“There’s a fundamental principle of neuro-obstetrics,” says Caroline Just, MD, a neurologist in Cleveland Clinic’s Center for General Neurology who specializes in obstetric neurology. “We want to empower patients with the right information to make their own risk-benefit decisions. We don’t want to assume that the risks always outweigh the benefits.”

In the latest episode of Cleveland Clinic’s Neuro Pathways podcast, Dr. Just discusses management of neurologic disorders during pregnancy as well as considerations for the preconception and postpartum periods. She covers:

  • Medications that pregnant individuals should avoid if they have various neurologic conditions
  • The importance of monitoring drug dosing levels during pregnancy
  • The use of C-section delivery and epidurals in women with neurologic disease
  • Therapeutic interventions that may influence birth control efficacy
  • How neurologic disorders may be impacted during the postpartum period
  • The importance of collaboration among neurologists, obstetricians and maternal-fetal medicine specialists in the care of pregnant patients with neurologic disorders

Click the podcast player above to listen to the 27-minute episode now, or read on for a short edited excerpt. Check out more Neuro Pathways episodes at clevelandclinic.org/neuropodcast or wherever you get your podcasts.

This activity has been approved for AMA PRA Category 1 Credit™ and ANCC contact hours. After listening to the podcast, you can claim your credit here.


Excerpt from the podcast

Podcast host Glen Stevens, DO, PhD: What do clinicians need to consider when an individual with an existing disorder becomes, or wants to become, pregnant?

Dr. Just: One thing that’s really important to know is that certain medications can be teratogenic, and their half-life is really important to know leading up to preconception, particularly for some of the newer medicines. For instance, there are CGRP [calcitonin gene-related peptide] inhibitors for migraine that have very long half-lives, so it’s imperative that we clinicians tell our patients to give us notice if they are planning on having a child or trying to get pregnant. Of course, a large percentage of pregnancies are unplanned, so it’s important to have a conversation about the possibility of pregnancy for all patients of childbearing potential.

Multiple sclerosis [MS] often calls for pregnancy-related considerations. Pregnancy definitely plays a role in MS treatment, and MS often plays a role in when people choose to get pregnant — whether they want to be off meds for longer if they are trying to conceive or if they’re considering fertility treatment. So pregnancy definitely plays a huge role there.

Another really important consideration arises with epilepsy. Many anti-seizure medicines are teratogenic, but many are only very slightly teratogenic while others are much more concerning. Knowing the difference between these degrees of teratogenicity is highly important. For example, there are very few scenarios in which a patient of childbearing potential should be taking valproate.


Related Articles

adult female figure suffering headache
June 17, 2024/Neurosciences/Podcast
Migraine Relief: Providing Preventive and Abortive Therapies (Podcast)

A close look at the growing array of options for episodic and chronic migraine

woman grabbing her back in pain
June 3, 2024/Neurosciences/Podcast
Shedding Light on Stiff Person Syndrome (Podcast)

Heightened awareness of this rare disorder may lead to better diagnosis and treatment progress

pills, syringes and vials on a tabletop
May 15, 2024/Neurosciences/Podcast
Multiple Sclerosis Medications: Making the Most of a Multitude of Options (Podcast)

Insights on the decision process for selecting a treatment approach

doctor applying force to patient's forearm to test strength
Offering Rehabilitation Care to Oncology Patients (Podcast)

New oncologic rehab program is tailored to managing the effects of cancer and its treatments

syringe being prepared for injection
April 15, 2024/Neurosciences/Podcast
Balancing Benefits and Pitfalls of Neurotoxin Injections (Podcast)

Determining the right dose and injecting in the right muscle can be challenging

inflammation on a brain scan with a podcast button overlay
April 2, 2024/Neurosciences/Podcast
Diagnosis and Management of Cerebral Amyloid Angiopathy-Related Inflammation (Podcast)

New research sheds light on a potentially devastating condition that is reversible when properly managed

photo of a man sleeping at a desk, with a podcast icon overlay
March 15, 2024/Neurosciences/Podcast
Diagnosis and Management of Idiopathic Hypersomnia (Podcast)

Testing options and therapies are expanding for this poorly understood sleep disorder

series of digital-looking brain icons with a podcast button overlay on top
March 1, 2024/Neurosciences/Podcast
Harnessing the Power of AI in Medicine (Podcast)

Neurology is especially well positioned for opportunities to enhance clinical care and medical training