Management of Myasthenia Gravis in Pregnancy

Waters, Janet

doi:10.1016/j.ncl.2018.09.003

Cited by 22 publications

(54 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Corticosteroid treatment is very effective in most MG patients and can be an option for treatment in pregnant women where immunosuppression therapy is needed to treat MG that is getting worse during pregnancy. The use of high doses of corticosteroids may be associated with premature rupture of membranes (Waters, 2019). The drug commonly used is prednisone at a dose of 1 mg / kg per day, given as a one-time dose (Chaudhry, Vignarajah, & Koren, 2012).…”

Section: Abstrakmentioning

confidence: 99%

“…Because of the serious side effects of longterm use of corticosteroids, steroid-sparing immunosuppression drugs have been developed, including azathioprine, cyclophosphamide, cyclosporine, methotrexated and and new mycophenolate mofetil (Chaudhry et al, 2012). The use of immunosuppressants should be avoided during pregnancy because of its teratogenic effects (Waters, 2019). Safety of the use of intravenous immunoglobulin in MG patients who are pregnant until now there has been no report.…”

Section: Abstrakmentioning

confidence: 99%

“…Neostigmine can be given at a dose of 1.5 mg intra-muscular or 0.5 mg intravenously (Téllez-Zenteno et al, 2004). Surgical action on patients with MG is an act that causes very heavy stress, therefore births with sectio caesarian measures are only performed in cases that are necessary only (Waters, 2019).…”

Section: Labormentioning

confidence: 99%

See 2 more Smart Citations

Pregnancy with Myasthenia Gravis

Ariningtyas¹,

Irfana²

2020

Qanun Medika

View full text Add to dashboard Cite

Myasthenia Gravis (MG) is a serious autoimmune disease, but now can be treated. Symptoms include weakness and fatigue in voluntary muscles caused by an autoantibody reaction to nicotinic acetylcholine receptor (AChR) at the post synapse of the neuromuscular junction. Pregnancy can affect autoimmune diseases so that pregnancy can aggravate MG disease. On the other hand it is also reported that pregnancy does not affect and can even improve MG disease. In this article, We report a 27-year-old woman who was diagnosed with myasthenia gravis that having a pregnancy. Initially she had no problems with pregnancy. Patients underwent pregnancy by taking the drug Mestinon four times daily and roborant. But entering the 33rd-34th week, the examination results showed that the pregnancy experienced oligohydramnios and Intrauterine Growth Retardation (IUGR), it was probably caused by malnutrition. Then we decided to end the patient's pregnancy with a Caesarean section. The operation went well, born to a baby boy / 2450grams / Apgar Score 5-7. Observation for one week the mother's condition continued to improve. Diplopia and weaknesses also improve. Likewise the baby showed a healthy condition. The patient was discharged while still taking MG drugs that had been previously consumed. This case report showed that pregnancy worsened MG disease, but MG did not affect pregnancy.Keywords : Pregnancy, Myasthenia Gravis

show abstract

Section: Abstrakmentioning

confidence: 99%

Section: Abstrakmentioning

confidence: 99%

See 1 more Smart Citation

Pregnancy with Myasthenia Gravis

Ariningtyas¹,

Irfana²

2020

Qanun Medika

View full text Add to dashboard Cite

show abstract

“…MG occurs twice as frequently in women than men and typically affects women of child-bearing age [3]. MG does not affect fertility, and pregnancy does not appear to have a long-term adverse impact on the course of the disease; therefore, pregnancy can be expected in women with gMG.…”

Section: Introductionmentioning

confidence: 99%

Eculizumab during Pregnancy in a Patient with Treatment-Refractory Myasthenia Gravis: A Case Report

Harvey

Suresh

et al. 2021

Case Rep Neurol

View full text Add to dashboard Cite

The recombinant humanized monoclonal antibody eculizumab has been shown to be effective and well tolerated in patients with anti-acetylcholine receptor antibody-positive, treatment-refractory generalized myasthenia gravis (gMG). Myasthenia gravis (MG) often affects women of child-bearing potential. However, management can be challenging during pregnancy, and current treatment options are limited due to potential teratogenicity. Data are currently lacking on the use of eculizumab in pregnant women with gMG. This case report describes a successful pregnancy in a young woman with treatment-refractory gMG treated with eculizumab before, during, and after pregnancy. Eculizumab appeared to have a favorable benefit-risk profile in this setting, with no treatment-related adverse effects noted in either the patient or the neonate. The patient remains neurologically stable on eculizumab, which she has now been receiving for 5 years. This first report of the use of eculizumab during pregnancy in a patient with treatment-refractory gMG suggests a potential role for eculizumab in this setting, although further clinical experience is necessary to support its use during pregnancy in women with MG.

show abstract

“…43, 4, 5]. С другой -плод также является объектом аутоиммунной агрессии со стороны организма матери вследствие трансплацентарной передачи материнских АТ с риском развития транзиторной неонатальной миастении (ТНМ) у 10-35% новорожденных [6][7][8][9][10]. Показано, что пассаж материнских АТ через фетоплацентарный барьер происходит во всех случаях и их титр в крови новорожденного сопоставим с титром материнских АТ [11].…”

unclassified

Frequency and risk factors for transient neonatal myasthenia

Khrushcheva

Щербакова

Шабалина

et al. 2019

jour

View full text Add to dashboard Cite

Цель. Определить частоту и изучить факторы риска транзиторной неонатальной миастении (ТНМ). Материалы и методы. В исследование включено 194 случая беременности у пациенток с аутоиммунной миастенией, наблюдавшихся в Научном центре неврологии с сентября 2015 г. по январь 2019 г. Для анализа объединены данные двух когорт-ретроспективной (151 беременность) и проспективной (43 беременности). ТНМ диагностирована у 31 (16%) новорожденного. Проведен однофакторный анализ особенностей течения миастении у матерей и характеристик новорожденных в группах с и без ТНМ. Для сравнения групп использованы t-критерий Стьюдента и c 2 Пирсона. Вычислены: отношение шансов (ОШ) и 95% доверительные интервалы (ДИ). Результаты. Риск ТНМ ассоциирован: с преимущественно туловищной формой заболевания у матери (ОШ 2,62; 95% ДИ 1,18-5,79), тяжелым дородовым течением миастении (IVA-B, V класс тяжести по классификации MGFA), недостигнутой ремиссией к началу беременности, обострениями миастении в III триместре (ОШ 4,72; 95% ДИ 2,09-10,69) и послеродовыми обострениями. Средние значения титра антител (АТ) к ацетилхолиновому рецептору (АХР) до беременности у матерей в группе детей с ТНМ были выше, чем в группе без ТНМ,-18,32 и 14,35 нмоль/л соответственно (p=0,002). У детей с ТНМ средний гестационный возраст и масса тела при рождении были меньше, чем у детей без ТНМ,-36,7 и 38,7 нед, 2814,8 и 3165,9 г соответственно (p<0,001). Доля АТ к эмбриональной форме АХР в пуповинной крови у ребенка с ТНМ составила 28% от общего титра АТ, у новорожденных без ТНМ (n=17)-83% [54; 88]. Заключение. Риск ТНМ ассоциирован с тяжелым течением миастении у матери, отсутствием ремиссии заболевания перед беременностью и более высоким титром АТ к АХР, обострением во второй половине беременности и после родов, а также с преимущественно туловищной формой заболевания. Недоношенность и малая масса тела при рождении-факторы риска ТНМ со стороны новорожденного. Ключевые слова: транзиторная неонатальная миастения, миастения, беременность, факторы риска, трансплацентарная передача аутоантител, ацетилхолиновый рецептор.

show abstract

Management of Myasthenia Gravis in Pregnancy

Cited by 22 publications

References 21 publications

Pregnancy with Myasthenia Gravis

Pregnancy with Myasthenia Gravis

Eculizumab during Pregnancy in a Patient with Treatment-Refractory Myasthenia Gravis: A Case Report

Frequency and risk factors for transient neonatal myasthenia

Contact Info

Product

Resources

About