There is no conclusive evidence that pregnancy exacerbates neuromyelitis optica (Uzawa et al 2014). A retrospective review of pregnant patients with neuromyelitis optica suggests that there may be an increased relapse rate after delivery (Kim et al 2012). Caution should be used in patients with neuromyelitis optica who are planning pregnancy, as medications used for prevention of neuromyelitis optica are not safe during pregnancy. Patients should wait at least 2 months after the last dose of rituximab before attempting conception. If a relapse occurs in a pregnant patient with neuromyelitis optica, steroids, plasmapheresis, or IVIG can be given safely.