title: Severe Preeclampsia in the Setting of Myasthenia Gravis.
abstract: Myasthenia gravis (MG) is a rare autoimmune disease that leads to progressive muscle weakness and is common during female reproductive years. The myasthenic mother and her newborn must be observed carefully, as complications during all stages of pregnancy and the puerperium may arise suddenly. Preeclampsia is a common obstetrical condition for which magnesium sulfate is used for seizure prophylaxis. However, magnesium sulfate is strongly contraindicated in MG as it impairs already slowed nerve-muscle connections. Similarly, many first-line antihypertensive medications, including calcium channels blockers andβ-blockers, may lead to MG exacerbation. This case describes the effective obstetrical management of a patient with MG who developed severe preeclampsia. The effective use of levetiracetam and various antihypertensive medications including intravenous labetalol is described. A review of the ten reported cases of MG complicated by preeclampsia is examined to aggregate observations of clinical care, with focus on delivery methods, anticonvulsants, and antihypertensive medications.
authors.affiliation: Department of Obstetrics and Gynecology, University of Illinois College of Medicine at Rockford, 1601 Parkview Ave., Rockford, IL 61101, USA.
authors.forename: Adam J
authors.identifier: 0000-0001-6729-0506
authors.initials: AJ
authors.lastname: Lake
authors.affiliation: Department of Obstetrics and Gynecology, University of Illinois College of Medicine at Rockford, 1601 Parkview Ave., Rockford, IL 61101, USA.
authors.forename: Antoun
authors.identifier: 0000-0001-5241-1993
authors.initials: A
authors.lastname: Al Khabbaz
authors.affiliation: Department of Women, Children, and Family Health, University of Illinois College of Nursing at Rockford, 1601 Parkview Ave., Rockford, IL 61101, USA.
authors.forename: Renée
authors.initials: R
authors.lastname: Keeney