Association of preeclampsia and myasthenia: a case report.
BACKGROUND
Myasthenia gravis in pregnancy is uncommon, and its occurrence in conjunction with preeclampsia is very rare but may be catastrophic for mother and child.


METHODS
A 31-year-old, multiparous woman, with a history of myasthenia gravis and thymectomy, presented at 27 weeks with worsening preeclampsia and delivered by cesarean section under spinal anesthesia. Preeclamptic crisis with hemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome developed postpartum. Blood pressures remained severely high. Intensive care management and a labetalol drip resolved the crisis.


CONCLUSIONS
Added complications may arise from myasthenic exacerbation, difficulties in early recognition of signs and symptoms, and the use of medications that slow neuromuscular transmission.
Hamaoui
Abraham
A
Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, Bronx, New York, USA. abraham.hamaoui@nychhc.org
Mercado
Ray
R
D000959:Antihypertensive Agents / Q000008:administration & dosage; D002585:Cesarean Section; D002800:Cholinesterase Inhibitors / Q000008:administration & dosage; D005260:Female; D017359:HELLP Syndrome / Q000188:drug therapy*; D006801:Humans; D007262:Infusions, Intravenous; D007741:Labetalol / Q000008:administration & dosage; D009157:Myasthenia Gravis / Q000150:complications* / Q000188:drug therapy*; D011225:Pre-Eclampsia / Q000188:drug therapy* / Q000601:surgery; D011247:Pregnancy; D011729:Pyridostigmine Bromide / Q000008:administration & dosage; D055815:Young Adult
D000959:Antihypertensive Agents; D002800:Cholinesterase Inhibitors; D011729:Pyridostigmine Bromide; D007741:Labetalol