Myasthenia gravis during pregnancy.
Myasthenia gravis (MG) affects women in the second and third decades of life, overlapping with the childbearing years. During pregnancy, the course of this disease is unpredictable; worsening of symptoms occurs more likely during the first half of pregnancy and postpartum. MG can be well managed during pregnancy with relatively safe and effective therapies. Cesarean section is recommended only for obstetric reasons; epidural anesthesia is advised to reduce physical and emotional stress. Anticholinesterase drugs are the mainstay of treatment, when MG symptoms are not satisfactorily controlled, corticosteroids, azathioprine and in some cases cyclosporin A may be used. Life-threatening conditions (e.g., respiratory insufficiency) may occur during pregnancy; therefore, intensive check-ups by a gynecologist and a neurologist are necessary.
Ferrero
Simone
S
Department of Obstetrics & Gynecology, San Martino Hospital & University of Genoa, Largo R. Benzi 1, 16132, Genoa, Italy. dr@simoneferrero.com
Esposito
Francesca
F
Biamonti
Mariangela
M
Bentivoglio
Giorgio
G
Ragni
Nicola
N
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D002800:Cholinesterase Inhibitors / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D009157:Myasthenia Gravis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000628:therapy*
D000893:Anti-Inflammatory Agents; D002800:Cholinesterase Inhibitors