Maternal VTE prophylaxis
We needed to consider about maternal VTE prophylaxis. In general, wheelchair use in daily life is a risk factor for developing VTE, and is at higher risk during pregnancy and postpartum period. In this case, she had never been treated for VTE before first pregnancy and her husband was physical therapist, we thought that she did not require anticoagulation agents such as unfractionated heparin during pregnancy. We told her prophylaxis for VTE, to wear graduated compression stocking and to be conducted aggressive physical therapy by her husband in daily life. She did not have a VTE during her three courses of pregnancy and childbirth and postpartum period.
We report here of one woman with HAM/TSP and her three consecutive courses of pregnancy and childbirth without complications on her and her baby. These findings suggest that women with HAM/TSP, even those who have spastic paraparesis and use a wheelchair in daily life, should not be discouraged from pregnancy.