Myasthenia gravis and pregnancy: retrospective evaluation of 27 pregnancies in a tertiary center and comparison with previous studies

Tanaçan, Atakan; Fadıloğlu, Erdem; Özten, Gonca; Güneş, Ali Can; Örgül, Gökçen; Beksaç, Mehmet Sinan

doi:10.1007/s11845-019-02029-0

Cited by 25 publications

(48 citation statements)

References 35 publications

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“…Postpartum deterioration occurred in 15 of 54 pregnancies (28%) in symptomatic (n = 31) but also in previously asymptomatic (n = 23) MG patients. 102 Deterioration of MG during pregnancy occurred in 11 of 27 (40%) retrospectively evaluated pregnancies from Turkey, 103 which is in accordance with previous data from Mexico. 104 A retrospective study on 17 MUSK-ab positive women with 27 pregnancies either after MG onset, after an average 9.7 years of disease duration (n = 4) or 17 years before disease onset (n = 23) revealed no relapse 12 months after delivery, no pre-eclampsia, stillbirths or birth defects in both groups.…”

Section: Fertility and Menopausesupporting

confidence: 85%

“…Mother Deterioration during pregnancy 0-50% (Ducci et al 101 ; Batocchi et al 102 ; Tanacan et al 103 ; Tellez-Zenteno et al 104 ; Santos et al 105 ; Hoff et al 106 101,104,112,113 A single case of neonatal myasthenic syndrome in the newborn of a mother with localised (ocular) seronegative MG has been reported. 114 Antibodies against AChR, MuSK and LRP4 were shown to be detectable in the newborn's circulation with and without neonatal MG. 115,116 Thus, distinct factors like binding affinity to the foetal type of AChR seem to determine whether neonatal myasthenic symptoms occur or not.…”

Section: Type Of Complication Frequency (%)mentioning

confidence: 99%

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Gender issues of antibody-mediated diseases in neurology: (NMOSD/autoimmune encephalitis/MG)

Altıntaş

Dargvainiene

Schneider‐Gold

et al. 2020

Ther Adv Neurol Disord

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Neuromyelitis optica spectrum disorder (NMOSD), autoimmune encephalitis (AE), myasthenia gravis (MG) and Lambert-Eaton myasthenic syndrome (LEMS) are antibody-mediated neurological diseases. They have mostly female predominance, affecting many women during childbearing age. Interactions between the underlying disease (or necessary treatment) and pregnancy can occur in every of these illnesses. Herein, we present the characteristics of NMOSD, AE, MG and LEMS in general, and review published data regarding the influence of the different diseases on fertility, pregnancy, puerperium, treatment strategy during pregnancy and post-partum period, and menopause but also male factors. We summarise key elements that should be borne in mind when confronted with such cases.

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Section: Fertility and Menopausesupporting

confidence: 85%

Section: Type Of Complication Frequency (%)mentioning

confidence: 99%

Gender issues of antibody-mediated diseases in neurology: (NMOSD/autoimmune encephalitis/MG)

Altıntaş

Dargvainiene

Schneider‐Gold

et al. 2020

Ther Adv Neurol Disord

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“…The multi-disciplinary team must take into account managing women considering to become pregnant. 3,6 MG is an auto-immune disorder affecting the women of reproductive age twice more than men. 5 Myasthenia neither has any effect on fertility, and it is not uncommon to witness patients who are pregnant, nor does the pregnancy have any effects on the disease course.…”

Section: Discussionmentioning

confidence: 99%

“…2,5 However, the disease exacerbations are seen mostly in the first trimester and post-partum. 3,[5][6] In a retrospective evaluation of pregnant women with myasthenia, the rate of C-section was as high as 78.3%. The rate of C-section in our study is 8.40% for all the NMDs combined.…”

Section: Discussionmentioning

confidence: 99%

“…Although C-section is necessitated, vaginal deliveries are considered safe in the absence of any myasthenia crisis. 6 Muscular dystrophies (MD) are a rare set of genetically inherited diseases, characterized by muscular weakness and wasting. 7 In prior surveys, complications like pre-term labor, placenta previa, and others are reported in myotonic dystrophy type 1.…”

Section: Discussionmentioning

confidence: 99%

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Obstetric-Gynecological Complications in Neuromuscular Disorders

Digala

Haider

Govindarajan

2020

rrnmf

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Background and Objective: The data on the obstetric and gynecological complications in patients diagnosed with neuromuscular diseases is very limited and is primarily obtained from various case reports, series, and small studies. The objective of our study was to analyze the prevalence of these complications in a large cohort of patients with various neuromuscular diseases. Methods: This study is a retrospective chart review of patients diagnosed with various neuromuscular diseases at the University of Missouri, Columbia, from 2012 to 2017. We included patients who have at least one year follow up with us. We collected data on patient demographics, neuromuscular disease diagnosed, obstetric complications, and gynecologic complications. Data are reported as means ± SEM, and the results reported using prevalence rates. Results: Ninety-five female patients were identified. Among them, 97% were Caucasian, and 3% were African-American with a mean age of 47.96 years. Neuromuscular diseases identified among them are Myasthenia Gravis (44%), Muscular Dystrophy (23%), Amyotrophic Lateral Sclerosis-ALS (16%), Charcot-Marie-Tooth disease-CMT (10%), and Spinal Muscular atrophy- SMA (7%). The majority of the patients reviewed have had no obstetric complications- (89.40%). The most common obstetric complication recorded was C-section (8.40%). 41% of women did not have any gynecological complaints. Urine incontinence (24.20%) is the most common complication. Conclusion: C-sections and urinary incontinence are common obstetric and gynecological events seen in women with neuromuscular disease.

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Myasthenic crisis

Claytor

Cho

2023

Muscle and Nerve

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Myasthenic crisis (MC) is a life‐threatening manifestation of myasthenia gravis (MG) defined by respiratory insufficiency that requires the use of invasive or non‐invasive ventilation. This is often the result of respiratory muscle weakness but can also be due to bulbar weakness with upper airway collapse. MC occurs in approximately 15%–20% of patients with MG usually within the first 2 to 3 y of the disease course. Many crises have a specific trigger with respiratory infections being most common; however, no specific trigger is found in 30%–40% of patients. MG patients with a history of MC, severe disease, oropharyngeal weakness, muscle‐specific kinase (MuSK) antibodies and thymoma appear to be at higher risk. Most episodes of MC do not occur suddenly, providing a window of opportunity for prevention. Immediate treatment is directed toward airway management and removing any identified triggers. Plasmapheresis is preferred over intravenous immune globulin as the treatments of choice for MC. The majority of patients are able to be weaned from mechanical ventilation within 1 mo and the outcomes of MC are generally favorable. The mortality rate in United States cohorts is less than 5% and mortality in MC seems to be driven by age and other medical co‐morbidities. MC does not appear to affect long‐term prognosis as many patients are able to eventually achieve good MG control.

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Myasthenia gravis and pregnancy: retrospective evaluation of 27 pregnancies in a tertiary center and comparison with previous studies

Cited by 25 publications

References 35 publications

Gender issues of antibody-mediated diseases in neurology: (NMOSD/autoimmune encephalitis/MG)

Gender issues of antibody-mediated diseases in neurology: (NMOSD/autoimmune encephalitis/MG)

Obstetric-Gynecological Complications in Neuromuscular Disorders

Myasthenic crisis

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