AI Article Synopsis
- Myasthenia gravis (MG) is an autoimmune disease that causes fluctuating muscle weakness, significantly impacting pregnant women and potentially affecting their newborns with conditions like transient neonatal myasthenia gravis (TNMG) and arthrogryposis multiplex congenita (AMC).
- A study analyzed 66 pregnancies among women with MG, finding that 63% experienced worsening symptoms during pregnancy, but no patients had a myasthenic crisis and the need for acute treatment was low.
- Overall, maternal and neonatal outcomes were positive, with normal rates of cesarean and slightly higher rates of operative vaginal delivery, providing valuable insights for healthcare providers advising MG patients who wish to have children.
Article Abstract
Purpose: Myasthenia gravis (MG) is a rare, potentially life-threatening autoimmune disease with fluctuating muscle weakness frequently affecting women of childbearing age. MG can affect maternal as well as neonatal outcome with risk of worsening of myasthenic symptoms in the mothers and risk of transient neonatal myasthenia gravis (TNMG) and arthrogryposis multiplex congenita (AMC) or foetal acetylcholine receptor antibody-associated disorders (FARAD) in the neonates.
Methods: Retrospective analysis of maternal and neonatal outcome in a cohort of pregnant MG patients treated at a tertiary care centre in Germany.
Results: Overall, 66 pregnancies were analysed. During 40 (63%) pregnancies, women experienced a worsening of myasthenic symptoms, of whom 10 patients (15.7%) needed acute therapy with IVIg or plasma exchange. There was no case of myasthenic crisis. Rate of caesarean section was comparable to the overall C-section rate at our centre (38% vs. 40%). However, there was a slightly higher rate for operative vaginal delivery (15% vs. 10%) as potential indicator for fatiguing striated musculature in MG patients during the expulsion stage. Rate of TNMG as well as AMC was 3% (two cases each).
Conclusions: Maternal and neonatal outcome in our cohort was favourable with a low rate of myasthenic exacerbations requiring acute therapies and a low rate of TNMG and AMC/FARAD. Our data might help neurologists and obstetricians to advice MG patients with desire to have children.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11168978 | PMC |
| http://dx.doi.org/10.1007/s00404-024-07436-y | DOI Listing |
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