Management of multiple chemical sensitivity syndrome in pregnancy

Multiple Chemical Sensitivity Syndrome is a poorly understood chronic disorder that causes multiple symptoms in various body systems and organs following exposure to chemicals at very low concentrations that are not considered to be harmful to the population. It is an overlapping and progressive process that mostly affects middle-aged women. In 1987 Cullen proposed the term MCS, but it was not until 1999 that a consensus was reached for its diagnosis based on Nethercott's criteria, which were published by Bartha. In Spain, the disease was recognized in 2014 and was included in the ICD-9-MC with the code 995, under the heading of Unspecified Allergies. A later update in 2016 of the ICD-10-MC classifies it as code T78.40. Its aetiopathogenesis is currently unknown, thus it has not been recognised by the WHO as a disease, but it is believed that genetic, allergenic, chemical, and anatomical factors may be involved. It is a neurological disease, with clear predisposing factors, which is made worse by physical overexertion or minimal psychological stress, as well as by exposure to chemical and environmental factors. Its diagnosis is fundamentally clinical, and it currently does not have a specific treatment. The case is presented of a pregnant woman affected by this disorder, who was cared for by a multidisciplinary team in the management of the childbirth and immediate puerperium. (C) 2020 Elsevier Espana, S.L.U. All rights reserved.