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
Related Articles
- EP ID EP14788
- DOI 10.18295/squmj.2017.17.03.002
- Views 344
- Downloads 18
Is a Team-based Learning Approach to Anatomy Teaching Superior to Didactic Lecturing?
Objectives: Team-based learning (TBL) is used in the medical feld to implement interactive learning in small groups. Te learning of anatomy and its subsequent application requires the students to recall a great deal of...
A Possible Case of Systemic Lupus Erythematosus Presenting with Generalised Oedema
Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown aetiology affecting various systems within the body. We report the case of a patient with generalised subcutaneous oedema as the only presenting f...
N0dular Lymphocyte Predominant Hodgkin’s Lymphoma Presenting as Severe Hypercalcaemia: A Case Report
Nodular lymphocyte predominant Hodgkin’s lymphoma (NLPHL) is a recently described type of Hodgkin’s lymphoma (HL) and accounts for 5-6% of all the cases of HL. Here we report the case of an elderly man who presented...
A Cerebellar High-Grade Neuroepithelial Tumour with BCOR Alteration in a five-year-old Child: A case report
New groups of high-grade neuroepithelial tumours (HGNET) have emerged from the reclassification of central nervous system (CNS) embryonal tumours that have recognised CNS HGNET with BCOR alteration (CNS HGNET-BCOR). We r...
Spinal Cord Infarction following Abdominal Surgery and Postoperative Epidural Analgaesia
Ischemic infarction is a rare cause of acute myelopathy. We report the case of a young woman admitted to Sultan Qaboos University Hospital, Oman, who developed extensive spinal cord infarction in the setting of surgica...