Myasthenia Gravis and Pregnancy

Mp, Snijders; J, de Graaff; Aa, Op de Coul

doi:10.1016/b978-0-12-384911-3.00003-8

Cited by 8 publications

(7 citation statements)

References 35 publications

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“…However, no similar correlation between prior MG status and exacerbation during pregnancy was found by Batocchi and colleagues 4 . Exacerbations of symptoms mostly occur in the first or second trimesters or after delivery 3,4,6 …”

Section: Impact Of Pregnancy On Mgmentioning

confidence: 88%

“…Exacerbations of symptoms mostly occur in the first or second trimesters or after delivery. 3,4,6 3 | IMPACT OF MG ON PREGNANCY MG is not known to affect pregnancy significantly. Some studies have shown preterm premature rupture of membranes and increased incidence of cesarean section due to uterine inertia, whereas other studies did not show similar adverse effects on the course of pregnancy or mode of delivery.…”

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confidence: 99%

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Myasthenia gravis and pregnancy

Grover

Sripathi

2020

Muscle and Nerve

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Myasthenia gravis (MG) is an autoimmune disorder with bimodal age of presentation, occurring in young women of reproductive age and at an older age in men. Occasionally, MG is diagnosed during pregnancy. Management of MG includes symptomatic treatment with cholinesterase inhibitors and immunosuppressive therapy for controlling the disease activity. Treatment of MG in women of reproductive age, who may be contemplating pregnancy, requires discussion regarding the choice of medication as well as the understanding of risks/adverse effects involved with various treatments. During the peripartum period, it is essential to ensure careful monitoring of the disease state along with the well-being of the mother and fetus and to coordinate neonatal monitoring overseen by a multidisciplinary team comprising a high-risk maternal fetal medicine specialist, a neurologist familiar with these complex issues, and a neonatologist.

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Section: Impact Of Pregnancy On Mgmentioning

confidence: 88%

mentioning

confidence: 99%

Myasthenia gravis and pregnancy

Grover

Sripathi

2020

Muscle and Nerve

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“…Bir olgu MG tanısı aldıktan sonra ilk bir yıl maternal mortalite açısından en yüksek risk grubundadır, yedi yıl sonra en düşük risk grubuna girer 7 . Bu nedenle yeni MG tanısı almış bir kadın en az iki yıl gebeliği ertelemelidir 7,8 . Gebeliğin MG üzerine uzun dönemde kötüleştirici etkisi olmasa da gebelik süresince hastanın klinik seyri oldukça değişken olabilmektedir.…”

Section: Gebeliğin Myastenia Gravis üZerine Etkisiunclassified

Myastenia Gravis ve Gebelik

Evlice¹,

Demır²

2016

Arşiv Kaynak Tarama Dergisi

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Öz Myastenia gravis nöromüsküler kavşağı tutan otoimmün bir hastalıktır ve bu tanıyı alan hastalarda operasyon sonrası solunum yetmezliği gelişme riski vardır. Aynı şekilde kronik obstrüktif akciğer hastalığı varlığında da postoperatif solunum yetmezliğinin gelişebileceği bilinmektedir. Ancak steroid yapılı nondepolarizan kas gevşeticiler ve bu kas gevşeticilerin etkilerini geri döndürmek için kullanılacak sugammadeks olası postoperatif solunum yetmezliği riskini en aza indirmektedir. Bu olgu sunumunda, acil laparotomi için roküronyum ile genel anestezi uygulanan myastenia gravis ve kronik obstrüktif akciğer hastalığı tanıları olan hastada sugammadeks ile postoperatif solunum yetmezliğinin önlenebildiği başarılı bir genel anestezi uygulamasını sunmak istedik. Anahtar Sözcükler: Myastenia gravis, sugammadex, roküronyum. Abstract Myastenia gravis is an autoimmune disease involving the neuromuscular junction and patients receiving this diagnosis have a risk of developing postoperative respiratory failure. Similarly, the presence of chronic obstructive lung disease is known to be associated with postoperative respiratory failure. However, steroidal non-depolarising muscle relaxants and sugammadex to reverse their muscle-relaxing effects minimize the risk of postoperative respiratory failure. In this case report, we wanted to present a successful application of general anesthesia with rocuronium for emergency laparotomy in a patient with myasthenia gravis and chronic obstructive pulmonary disease in whom postoperative respiratory failure could be prevented by using sugammadex. Giriş Myastenia gravis (MG), nöromüsküler kavşakta postsinaptik asetin kolin reseptörlerine karşı antikorların varlığı ile karakterize bir hastalıktır. Nöromüsküler son plakta sinyal iletiminin bozulması yorgunluk ve kas güçsüzlüğü ile kendini gösterir. Bu nedenle nöromüsküler blokaj uygulanan bu hastalarda postoperatif dönemde solunum yetmezliği riski yüksektir. MG tanılı hastalar operasyon sırasında ve derlenme süresince nöromüsküler monitörizasyonla izlenmeli olası bir rezidüel bloğa karşı hazırlıklı olunmalıdır (1). MG'de depolarizan kas gevşeticilere karşı direnç gözlenir. Non-depolarizan kas gevşeticiler ile ise uzamış nöromüsküler blokaj oluşabilir (2). MG tanılı hastalarda nöromüsküler bloker ajan seçiminde steroid yapılı olanların (veküronyum ve roküronyum) tercih edilmesi nöromüsküler etkinin ortadan kaldırılmasında sugammadeks kullanılması açısından önemlidir.

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“…In one study, while 30% of patients did not show any change in the status of MG, 29% reported improvement and 41% reported worsening of myasthenic symptoms during pregnancy. [5] Worsening of myasthenic symptoms was usually seen during 1 st trimester and in 1 st month following delivery while the improvement of myasthenic symptoms was reported during 2 nd and 3 rd trimesters likely related to pregnancy-induced immunosuppression which occurs during these trimesters. [456] The main causes of exacerbations of MG during pregnancy include: (a) hypoventilation due to weakness of respiratory muscles and elevation of diaphragm during pregnancy, (b) puerperal infections, (c) drugs, as well as (d) stress of labor and delivery.…”

Section: Introductionmentioning

confidence: 99%

Management of myasthenia gravis during pregnancy

Bansal

Goyal²,

Modi

2018

Indian J Pharmacol

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The management of myasthenia gravis (MG) during pregnancy requires special skills as both diseases as well as its treatment can have deleterious effects on mother and fetus. MG often affects women in second and third decades of life during the childbearing age. Exacerbations of MG are likely to occur during the first trimester and postpartum period. The treatment of MG during pregnancy needs to be individualized depending on the severity of MG as well as the efficacy of various treatment modalities and their possible harmful effects on pregnancy. In addition, special attention has to be given to avoid drugs and other factors (such as urinary tract infections) which may worsen MG. The key to successful outcome during pregnancy in myasthenic women lies in multidisciplinary care involving obstetricians, neurologists, anesthetist as well as neonatologist. In this review, we discuss various therapeutic options available for the management of MG during pregnancy and provide recommendations based on the current best evidence.

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Myasthenia Gravis and Pregnancy

Cited by 8 publications

References 35 publications

Myasthenia gravis and pregnancy

Myasthenia gravis and pregnancy

Myastenia Gravis ve Gebelik

Management of myasthenia gravis during pregnancy

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