Myasthenia gravis during pregnancy: what care should be taken?

Ducci, Renata Dal‐Prá; Kay, Cláudia Suemi Kamoi; Fustes, Otto Jesús Hernández; Werneck, Lineü Cesar; Lorenzoni, Paulo José; Scola, Rosana Hermínia

doi:10.1590/0004-282x-anp-2020-0407

Cited by 4 publications

(3 citation statements)

References 45 publications

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“…On the one hand, it can not only maintain the MG course, but also change Th 1 and 2 cell populations to help infertility associated with maternal‐fetal immune abnormalities, without confirmed teratogenicity according to previous studies 34 . TAC is compatible with pregnancy and lactation according to the European League Against Rheumatism, 35 and also purposed utility in MG pregnant women by practice guidelines in some countries 36,37 . On the other hand, recent research found a strong decrease in uterine HLA‐DR+ Treg and maternal blood Treg in women who received TAC 38 .…”

Section: Discussionmentioning

confidence: 99%

“…34 TAC is compatible with pregnancy and lactation according to the European League Against Rheumatism, 35 and also purposed utility in MG pregnant women by practice guidelines in some countries. 36,37 On the other hand, recent research found a strong decrease in uterine HLA-DR+ Treg and maternal blood Treg in women who received TAC. 38 It has been demonstrated that an impairment in Treg number and function can result in the loss of immune tolerance, and thus the emergence of an uncontrolled autoimmune response.…”

Section: Impact Of Mg On Fetal Adverse Outcomesmentioning

confidence: 99%

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Risk factors associated with adverse pregnancy outcomes and postpartum exacerbation in women with myasthenia gravis

Zhou

Yin

Zhu

et al. 2022

American J Rep Immunol

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Problem: Myasthenia gravis (MG), an autoimmune neuromuscular disease affecting women of childbearing age, exerts an impact on pregnancy, and vice versa. The purposes of the study were to evaluate adverse pregnancy outcomes and postpartum exacerbation in a cohort of Asian MG women, and to explore the predictors for these outcomes. Methods of Study:Thirty-seven MG pregnancies of 33 women followed in Xiangya and the second Xiangya hospitals between January 2012 and January 2022, were included in this study. Baseline maternal data, maternal complications, and neonatal outcomes were extracted from medical records. MG courses were evaluated during pregnancy and postpartum 1 year.Results: In 5.4% of cases, MG exacerbation was reported during gestation, mostly in the third trimester, and in 38.9% in the postpartum period. Maternal complications were measured in 59.5% of women, gestational diabetes mellitus (GDM) taking the lead (29.7%) followed by premature rupture of membranes (PROMs) (18.9%). Transient neonatal MG (TNMG) and hyperbilirubinemia (HB) were seen in 24.3% of newborns.Body mass index (BMI) was the only independent predictor for maternal obstetric complications (p = .017), while thyroid disorders for GDM (p = .006). Younger mothers tended to give birth to babies with TNMG (p = .015). Primipara was the only risk factor for HB (p = .015). Higher gestational BMI gain (GBG) (p = .049) and without thyroid disorder (p = .017) were independent risk factors for puerperal exacerbation. Activated partial thromboplastin time and thyroid-stimulating hormone levels could be reliable to predict puerperal exacerbation. Conclusions:Most MG patients have unaffected courses during pregnancy but face a higher rate of maternal and fetal complications. Risk factors identified in our study aid the management of pregnancy in MG women.

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Section: Discussionmentioning

confidence: 99%

Section: Impact Of Mg On Fetal Adverse Outcomesmentioning

confidence: 99%

Risk factors associated with adverse pregnancy outcomes and postpartum exacerbation in women with myasthenia gravis

Zhou

Yin

Zhu

et al. 2022

American J Rep Immunol

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“…A assistência efetiva e humanizada, proporciona melhora no prognóstico do paciente e além do sentimento de realização profissional dos envolvidos. (Ducci et al, 2021).…”

Section: Conclusãounclassified

Cuidados de enfermagem ao paciente com Miastenia Grave: Revisão Integrativa de Literatura

Weizemann

Cheffer

Capelario

et al. 2022

RSD

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A miastenia grave (MG) é uma doença autoimune e crônica, caracterizada pela interrupção da comunicação neuromuscular, sendo que sua causa ainda não foi totalmente elucidada. O objetivo desse estudo é analisar como a enfermagem auxilia no processo de melhoria da doença. Trata-se de uma revisão integrativa de literatura, realizada durante os meses de agosto e dezembro de 2022, nas bases de dados SCIELO, LILACS, BRISA e MEDLINE, com auxílio dos Descritores em Ciências da Saúde (DeCS): Miastenia Gravis; Síndrome Miastênica Congênita do Canal Lento e Atividade Motora, os critérios de inclusão foram artigos em português e inglês, publicados entre 2018 e 2022 e gratuitos, já os critérios de exclusão foram estudos duplicados e que fugiam do tema. Após a triagem dos artigos, conforme os critérios de inclusão e exclusão, foram selecionados apenas 6 artigos para compor a amostra final. Concluiu-se que, o apoio da equipe de enfermagem ao acolher, encorajar, monitorar e auxiliar a paciente, aliado a terapia medicamentosa e à atenção da equipe multiprofissional proporcionaram a rápida melhora nos quadros de Miastenia Grave.

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