Myasthaenia Gravis Clinical management issues before, during and after pregnancy
Journal Title: Sultan Qaboos University Medical Journal - Year 2017, Vol 17, Issue 3
Abstract
Myasthaenia gravis (MG) is an autoimmune neuromuscular disorder which is twice as common among women, often presenting in the second and third decades of life. Typically, the frst trimester of pregnancy and frst month postpartum are considered high-risk periods for MG exacerbations. During pregnancy, treatment for MG is usually individualised, thus improving its management. Plasma exchange and immunoglobulin therapies can be safely used to treat severe manifestations of the disease or myasthaenic crises. However, thymectomies are not recommended because of the delayed benefcial effects and possible risks associated with the surgery. Assisted vaginal delivery—either vacuum-assisted or with forceps—may be required during labour, although a Caesarean section under epidural anaesthesia should be reserved only for standard obstetric indications. Myasthaenic women should not be discouraged from attempting to conceive, provided that they seek comprehensive counselling and ensure that the disease is under good control before the start of the pregnancy.
Authors and Affiliations
Ali Hassan | Department of Neurology, King Fahd Hospital, University of Dammam, Khobar, Saudi Arabia, Zakia M. Yasawy| Department of Neurology, King Fahd Hospital, University of Dammam, Khobar, Saudi Arabia
Keywords
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- EP ID EP14788
- DOI 10.18295/squmj.2017.17.03.002
- Views 316
- Downloads 18
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