Download PDF
Semin Neurol 2017; 37(06): 643-652
DOI: 10.1055/s-0037-1608785
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Neuromuscular Disorders in Pregnancy

Christyn Edmundson
1   Neuromuscular Division, Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
,
Amanda C. Guidon
2   Department of Neurology, Neuromuscular Division, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
› Author Affiliations
Further Information

Publication History

Publication Date:
21 December 2017 (online)

    Permissions and Reprints

Abstract

Neuromuscular disorders may present and progress differently in women than in men. During pregnancy, medication adjustment, hormonal effects, and other alterations in physiology may influence the manifestation of a variety of neuromuscular disorders. The expression of existing conditions may change; previously asymptomatic conditions may be unmasked, or entirely new conditions may develop. Additionally, neuromuscular disorders and their treatments may have implications for the fetus. Such factors must be carefully considered when counseling and treating pregnant women and those considering pregnancy. This article reviews considerations specific to women and issues surrounding pregnancy in disorders of the neuromuscular junction, focal neuropathies, and acquired and inherited disorders of the nerve and muscle.

Keywords

neuromuscular disease - pregnancy - myasthenia gravis - neuropathy - myopathy
 

  • References

  • 1 Amato AA, Russell JA. Neuromuscular Disorders. 2nd ed. Boston: McGraw-Hill Education Medical; 2016
    Google Scholar
  • 2 Grob D, Brunner N, Namba T, Pagala M. Lifetime course of myasthenia gravis. Muscle Nerve 2008; 37 (02) 141-149
    CrossrefPubMedGoogle Scholar
  • 3 Sanders DB, Wolfe GI, Benatar M. , et al. International consensus guidance for management of myasthenia gravis: executive summary. Neurology 2016; 87 (04) 419-425
    CrossrefPubMedGoogle Scholar
  • 4 Mays J, Butts CL. Intercommunication between the neuroendocrine and immune systems: focus on myasthenia gravis. Neuroimmunomodulation 2011; 18 (05) 320-327
    CrossrefPubMedGoogle Scholar
  • 5 Leker RR, Karni A, Abramsky O. Exacerbation of myasthenia gravis during the menstrual period. J Neurol Sci 1998; 156 (01) 107-111
    CrossrefPubMedGoogle Scholar
  • 6 Frenkel M. Treatment of myasthenia gravis by ovulatory suppression. Arch Neurol 1964; 11: 613-617
    CrossrefPubMedGoogle Scholar
  • 7 Stickler DE, Stickler LL. Single-fiber electromyography during menstrual exacerbation and ovulatory suppression in MuSK antibody-positive myasthenia gravis. Muscle Nerve 2007; 35 (06) 808-811
    CrossrefPubMedGoogle Scholar
  • 8 Djelmis J, Sostarko M, Mayer D, Ivanisevic M. Myasthenia gravis in pregnancy: report on 69 cases. Eur J Obstet Gynecol Reprod Biol 2002; 104 (01) 21-25
    CrossrefPubMedGoogle Scholar
  • 9 Delpy L, Douin-Echinard V, Garidou L, Bruand C, Saoudi A, Guéry JC. Estrogen enhances susceptibility to experimental autoimmune myasthenia gravis by promoting type 1-polarized immune responses. J Immunol 2005; 175 (08) 5050-5057
    CrossrefPubMedGoogle Scholar
  • 10 Wu KH, Tobias ML, Kelley DB. Estrogen and laryngeal synaptic strength in Xenopus laevis: opposite effects of acute and chronic exposure. Neuroendocrinology 2001; 74 (01) 22-32
    CrossrefPubMedGoogle Scholar
  • 11 Wargon I, Richard P, Kuntzer T. , et al. Long-term follow-up of patients with congenital myasthenic syndrome caused by COLQ mutations. Neuromuscul Disord 2012; 22 (04) 318-324
    CrossrefPubMedGoogle Scholar
  • 12 Servais L, Baudoin H, Zehrouni K. , et al. Pregnancy in congenital myasthenic syndrome. J Neurol 2013; 260 (03) 815-819
    CrossrefPubMedGoogle Scholar
  • 13 Wakata N, Nemoto H, Sugimoto H. , et al. Bone density in myasthenia gravis patients receiving long-term prednisolone therapy. Clin Neurol Neurosurg 2004; 106 (02) 139-141
    CrossrefPubMedGoogle Scholar
  • 14 Pouwels S, de Boer A, Javaid MK. , et al. Fracture rate in patients with myasthenia gravis: the general practice research database. Osteoporos Int 2013; 24 (02) 467-476
    CrossrefPubMedGoogle Scholar
  • 15 Yeh JH, Chen HJ, Chen YK, Chiu HC, Kao CH. Increased risk of osteoporosis in patients with myasthenia gravis: a population-based cohort study. Neurology 2014; 83 (12) 1075-1079
    CrossrefPubMedGoogle Scholar
  • 16 Grossman JM, Gordon R, Ranganath VK. , et al. American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis Care Res (Hoboken) 2010; 62 (11) 1515-1526
    CrossrefPubMedGoogle Scholar
  • 17 Attar SM. Adverse effects of low dose methotrexate in rheumatoid arthritis patients. A hospital-based study. Saudi Med J 2010; 31 (08) 909-915
    PubMedGoogle Scholar
  • 18 Sonthalia S, Daulatabad D. Azathioprine-associated anagen effluvium. Indian J Dermatol Venereol Leprol 2016; 82 (03) 322-324
    CrossrefPubMedGoogle Scholar
  • 19 Norwood F, Dhanjal M, Hill M. , et al. Myasthenia in pregnancy: best practice guidelines from a U.K. multispecialty working group. J Neurol Neurosurg Psychiatry 2014; 85 (05) 538-543
    CrossrefPubMedGoogle Scholar
  • 20 Ohlraun S, Hoffmann S, Klehmet J. , et al. Impact of myasthenia gravis on family planning: How do women with myasthenia gravis decide and why?. Muscle Nerve 2015; 52 (03) 371-379
    CrossrefPubMedGoogle Scholar
  • 21 Ciafaloni E, Massey JM. Myasthenia gravis and pregnancy. Neurol Clin 2004; 22 (04) 771-782
    CrossrefPubMedGoogle Scholar
  • 22 Massey JM, De Jesus-Acosta C. Pregnancy and myasthenia gravis. Continuum (Minneap Minn) 2014; 20 (1 Neurology of Pregnancy): 115-127
    PubMedGoogle Scholar
  • 23 Batocchi AP, Majolini L, Evoli A, Lino MM, Minisci C, Tonali P. Course and treatment of myasthenia gravis during pregnancy. Neurology 1999; 52 (03) 447-452
    CrossrefPubMedGoogle Scholar
  • 24 Braga AC, Pinto C, Santos E, Braga J. Myasthenia gravis in pregnancy: experience of a Portuguese center. Muscle Nerve 2016; 54 (04) 715-720
    CrossrefPubMedGoogle Scholar
  • 25 Ducci RD, Lorenzoni PJ, Kay CS, Werneck LC, Scola RH. Clinical follow-up of pregnancy in myasthenia gravis patients. Neuromuscul Disord 2017; 27 (04) 352-357
    CrossrefPubMedGoogle Scholar
  • 26 Carmichael SL, Shaw GM, Ma C, Werler MM, Rasmussen SA, Lammer EJ. ; National Birth Defects Prevention Study. Maternal corticosteroid use and orofacial clefts. Am J Obstet Gynecol 2007; 197 (06) 585.e1-585.e7 , discussion 683–684, e1–e7
    CrossrefPubMedGoogle Scholar
  • 27 Park-Wyllie L, Mazzotta P, Pastuszak A. , et al. Birth defects after maternal exposure to corticosteroids: prospective cohort study and meta-analysis of epidemiological studies. Teratology 2000; 62 (06) 385-392
    CrossrefPubMedGoogle Scholar
  • 28 Hviid A, Mølgaard-Nielsen D. Corticosteroid use during pregnancy and risk of orofacial clefts. CMAJ 2011; 183 (07) 796-804
    CrossrefPubMedGoogle Scholar
  • 29 Skuladottir H, Wilcox AJ, Ma C. , et al. Corticosteroid use and risk of orofacial clefts. Birth Defects Res A Clin Mol Teratol 2014; 100 (06) 499-506
    CrossrefPubMedGoogle Scholar
  • 30 Guidon AC, Massey EW. Neuromuscular disorders in pregnancy. Neurol Clin 2012; 30 (03) 889-911
    CrossrefPubMedGoogle Scholar
  • 31 Clark AL. Clinical uses of intravenous immunoglobulin in pregnancy. Clin Obstet Gynecol 1999; 42 (02) 368-380
    CrossrefPubMedGoogle Scholar
  • 32 Wolfe GI, Kaminski HJ, Cutter GR. Randomized trial of thymectomy in myasthenia gravis. N Engl J Med 2016; 375 (20) 2006-2007
    PubMedGoogle Scholar
  • 33 Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol 2009; 33 (03) 130-137
    CrossrefPubMedGoogle Scholar
  • 34 Haider B, von Oertzen J. Neurological disorders. Best Pract Res Clin Obstet Gynaecol 2013; 27 (06) 867-875
    CrossrefPubMedGoogle Scholar
  • 35 Ozcan J, Balson IF, Dennis AT. New diagnosis myasthenia gravis and preeclampsia in late pregnancy. BMJ Case Rep 2015; 2015: bcr2014208323 . Doi: 10.1136/bcr-2014-208323
    PubMedGoogle Scholar
  • 36 Hoff JM, Daltveit AK, Gilhus NE. Myasthenia gravis in pregnancy and birth: identifying risk factors, optimising care. Eur J Neurol 2007; 14 (01) 38-43
    CrossrefPubMedGoogle Scholar
  • 37 O'carroll P, Bertorini TE, Jacob G, Mitchell CW, Graff J. Transient neonatal myasthenia gravis in a baby born to a mother with new-onset anti-MuSK-mediated myasthenia gravis. J Clin Neuromuscul Dis 2009; 11 (02) 69-71
    CrossrefPubMedGoogle Scholar
  • 38 Niks EH, Verrips A, Semmekrot BA. , et al. A transient neonatal myasthenic syndrome with anti-musk antibodies. Neurology 2008; 70 (14) 1215-1216
    CrossrefPubMedGoogle Scholar
  • 39 Townsel C, Keller R, Johnson K, Hussain N, Campbell WA. Seronegative maternal ocular myasthenia gravis and delayed transient neonatal myasthenia gravis. AJP Rep 2016; 6 (01) e133-e136
    Article in Thieme ConnectPubMedGoogle Scholar
  • 40 Ahlsten G, Lefvert AK, Osterman PO, Stålberg E, Säfwenberg J. Follow-up study of muscle function in children of mothers with myasthenia gravis during pregnancy. J Child Neurol 1992; 7 (03) 264-269
    CrossrefPubMedGoogle Scholar
  • 41 D'Amico A, Bertini E, Bianco F. , et al. Fetal acetylcholine receptor inactivation syndrome and maternal myasthenia gravis: a case report. Neuromuscul Disord 2012; 22 (06) 546-548
    CrossrefPubMedGoogle Scholar
  • 42 Hacohen Y, Jacobson LW, Byrne S. , et al. Fetal acetylcholine receptor inactivation syndrome: A myopathy due to maternal antibodies. Neurol Neuroimmunol Neuroinflamm 2014; 2 (01) e57
    PubMedGoogle Scholar
  • 43 Oskoui M, Jacobson L, Chung WK. , et al. Fetal acetylcholine receptor inactivation syndrome and maternal myasthenia gravis. Neurology 2008; 71 (24) 2010-2012
    CrossrefPubMedGoogle Scholar
  • 44 Katz A, Sergienko R, Dior U, Wiznitzer A, Kaplan DM, Sheiner E. Bell's palsy during pregnancy: is it associated with adverse perinatal outcome?. Laryngoscope 2011; 121 (07) 1395-1398
    CrossrefPubMedGoogle Scholar
  • 45 Phillips KM, Heiser A, Gaudin R, Hadlock TA, Jowett N. Onset of Bell's palsy in late pregnancy and early puerperium is associated with worse long-term outcomes. Laryngoscope 2017; 127 (12) 2854-2859
    CrossrefPubMedGoogle Scholar
  • 46 Vrabec JT, Isaacson B, Van Hook JW. Bell's palsy and pregnancy. Otolaryngol Head Neck Surg 2007; 137 (06) 858-861
    CrossrefPubMedGoogle Scholar
  • 47 Monini S, Lazzarino AI, Iacolucci C, Buffoni A, Barbara M. Epidemiology of Bell's palsy in an Italian Health District: incidence and case-control study. Acta Otorhinolaryngol Ital 2010; 30 (04) 198-204
    PubMedGoogle Scholar
  • 48 Shmorgun D, Chan WS, Ray JG. Association between Bell's palsy in pregnancy and pre-eclampsia. QJM 2002; 95 (06) 359-362
    CrossrefPubMedGoogle Scholar
  • 49 Gronseth GS, Paduga R. ; American Academy of Neurology. Evidence-based guideline update: steroids and antivirals for Bell palsy: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology 2012; 79 (22) 2209-2213
    CrossrefPubMedGoogle Scholar
  • 50 Gillman GS, Schaitkin BM, May M, Klein SR. Bell's palsy in pregnancy: a study of recovery outcomes. Otolaryngol Head Neck Surg 2002; 126 (01) 26-30
    CrossrefPubMedGoogle Scholar
  • 51 Pasternak B, Hviid A. Use of acyclovir, valacyclovir, and famciclovir in the first trimester of pregnancy and the risk of birth defects. JAMA 2010; 304 (08) 859-866
    CrossrefPubMedGoogle Scholar
  • 52 Padua L, Di Pasquale A, Pazzaglia C, Liotta GA, Librante A, Mondelli M. Systematic review of pregnancy-related carpal tunnel syndrome. Muscle Nerve 2010; 42 (05) 697-702
    CrossrefPubMedGoogle Scholar
  • 53 Mondelli M, Rossi S, Monti E. , et al. Prospective study of positive factors for improvement of carpal tunnel syndrome in pregnant women. Muscle Nerve 2007; 36 (06) 778-783
    CrossrefPubMedGoogle Scholar
  • 54 Stolp-Smith KA, Pascoe MK, Ogburn Jr PL. Carpal tunnel syndrome in pregnancy: frequency, severity, and prognosis. Arch Phys Med Rehabil 1998; 79 (10) 1285-1287
    CrossrefPubMedGoogle Scholar
  • 55 Moghtaderi AR, Moghtaderi N, Loghmani A. Evaluating the effectiveness of local dexamethasone injection in pregnant women with carpal tunnel syndrome. J Res Med Sci 2011; 16 (05) 687-690
    PubMedGoogle Scholar
  • 56 Skeen MB, Eggleston M. Thoraconeuralgia gravidarum. Muscle Nerve 1999; 22 (06) 779-780
    CrossrefPubMedGoogle Scholar
  • 57 Pleet AB, Massey EW. Intercostal neuralgia of pregnancy. JAMA 1980; 243 (08) 770
    CrossrefPubMedGoogle Scholar
  • 58 Lederman RJ, Wilbourn AJ. Postpartum neuralgic amyotrophy. Neurology 1996; 47 (05) 1213-1219
    CrossrefPubMedGoogle Scholar
  • 59 van Alfen N, van Engelen BG. The clinical spectrum of neuralgic amyotrophy in 246 cases. Brain 2006; 129 (Pt 2): 438-450
    CrossrefPubMedGoogle Scholar
  • 60 Roubal PJ, Chavinson AH, LaGrandeur RM. Bilateral radial nerve palsies from use of the standard birthing bar. Obstet Gynecol 1996; 87 (5 Pt 2): 820-821
    PubMedGoogle Scholar
  • 61 Richard A, Vellieux G, Abbou S, Benifla JL, Lozeron P, Kubis N. Good prognosis of postpartum lower limb sensorimotor deficit: a combined clinical, electrophysiological, and radiological follow-up. J Neurol 2017; 264 (03) 529-540
    CrossrefPubMedGoogle Scholar
  • 62 Wong CA, Scavone BM, Dugan S. , et al. Incidence of postpartum lumbosacral spine and lower extremity nerve injuries. Obstet Gynecol 2003; 101 (02) 279-288
    PubMedGoogle Scholar
  • 63 Klein A. Peripheral nerve disease in pregnancy. Clin Obstet Gynecol 2013; 56 (02) 382-388
    CrossrefPubMedGoogle Scholar
  • 64 Amundsen S, Nordeng H, Nezvalová-Henriksen K, Stovner LJ, Spigset O. Pharmacological treatment of migraine during pregnancy and breastfeeding. Nat Rev Neurol 2015; 11 (04) 209-219
    PubMedGoogle Scholar
  • 65 LaBan MM, Rapp NS, von Oeyen P, Meerschaert JR. The lumbar herniated disk of pregnancy: a report of six cases identified by magnetic resonance imaging. Arch Phys Med Rehabil 1995; 76 (05) 476-479
    CrossrefPubMedGoogle Scholar
  • 66 Ardaillon H, Laviv Y, Arle JE, Kasper EM. Lumbar disk herniation during pregnancy: a review on general management and timing of surgery. Acta Neurochir (Wien) 2017; (e-pub ahead of print) DOI: 10.1007/s00701-017-3098-z.
    CrossrefPubMedGoogle Scholar
  • 67 Cheng Q, Jiang GX, Fredrikson S, Link H, de Pedro-Cuesta J. Increased incidence of Guillain–Barré syndrome postpartum. Epidemiology 1998; 9 (06) 601-604
    PubMedGoogle Scholar
  • 68 Lupo J, Germi R, Jean D. , et al. Guillain–Barré syndrome and cytomegalovirus infection during pregnancy. J Clin Virol 2016; 79: 74-76
    CrossrefPubMedGoogle Scholar
  • 69 Pollak-Christian E, Lee KS. Importance of diagnostic work-up of Guillain–Barré syndrome in pregnancy. BMJ Case Rep 2016; DOI: 10.1136/bcr-2016-216826.
    CrossrefPubMedGoogle Scholar
  • 70 Krauer F, Riesen M, Reveiz L. , et al; WHO Zika Causality Working Group. Zika virus infection as a cause of congenital brain abnormalities and Guillain–Barré syndrome: systematic review. PLoS Med 2017; 14 (01) e1002203
    CrossrefPubMedGoogle Scholar
  • 71 Hughes RA, Swan AV, van Doorn PA. Intravenous immunoglobulin for Guillain-Barré syndrome. Cochrane Database Syst Rev 2014; DOI: 10.1002/14651858.CD002063.pub6. : CD002063
    CrossrefPubMedGoogle Scholar
  • 72 Chan LY, Tsui MH, Leung TN. Guillain–Barré syndrome in pregnancy. Acta Obstet Gynecol Scand 2004; 83 (04) 319-325
    PubMedGoogle Scholar
  • 73 Ioannides ZA, Airey C, Fagermo N, Blum S, McCombe PA, Henderson RD. Susac syndrome and multifocal motor neuropathy first manifesting in pregnancy. Aust N Z J Obstet Gynaecol 2013; 53 (03) 314-317
    CrossrefPubMedGoogle Scholar
  • 74 Chaudhry V, Escolar DM, Cornblath DR. Worsening of multifocal motor neuropathy during pregnancy. Neurology 2002; 59 (01) 139-141
    CrossrefPubMedGoogle Scholar
  • 75 McCombe PA, McManis PG, Frith JA, Pollard JD, McLeod JG. Chronic inflammatory demyelinating polyradiculoneuropathy associated with pregnancy. Ann Neurol 1987; 21 (01) 102-104
    CrossrefPubMedGoogle Scholar
  • 76 Rudnik-Schöneborn S, Röhrig D, Nicholson G, Zerres K. Pregnancy and delivery in Charcot–Marie–Tooth disease type 1. Neurology 1993; 43 (10) 2011-2016
    CrossrefPubMedGoogle Scholar
  • 77 Awater C, Zerres K, Rudnik-Schöneborn S. Pregnancy course and outcome in women with hereditary neuromuscular disorders: comparison of obstetric risks in 178 patients. Eur J Obstet Gynecol Reprod Biol 2012; 162 (02) 153-159
    CrossrefPubMedGoogle Scholar
  • 78 Hoff JM, Gilhus NE, Daltveit AK. Pregnancies and deliveries in patients with Charcot–Marie–Tooth disease. Neurology 2005; 64 (03) 459-462
    CrossrefPubMedGoogle Scholar
  • 79 Rudnik-Schöneborn S, Zerres K, Ignatius J, Rietschel M. Pregnancy and spinal muscular atrophy. J Neurol 1992; 239 (01) 26-30
    CrossrefPubMedGoogle Scholar
  • 80 Hopkins AN, Alshaeri T, Akst SA, Berger JS. Neurologic disease with pregnancy and considerations for the obstetric anesthesiologist. Semin Perinatol 2014; 38 (06) 359-369
    CrossrefPubMedGoogle Scholar
  • 81 Flunt D, Andreadis N, Menadue C, Welsh AW. Clinical commentary: obstetric and respiratory management of pregnancy with severe spinal muscular atrophy. Obstet Gynecol Int 2009; DOI: 10.1155/2009/942301.
    CrossrefPubMedGoogle Scholar
  • 82 Finkel RS, Chiriboga CA, Vajsar J. , et al. Treatment of infantile-onset spinal muscular atrophy with nusinersen: a phase 2, open-label, dose-escalation study. Lancet 2016; 388 (10063): 3017-3026
    CrossrefPubMedGoogle Scholar
  • 83 Sax TW, Rosenbaum RB. Neuromuscular disorders in pregnancy. Muscle Nerve 2006; 34 (05) 559-571
    CrossrefPubMedGoogle Scholar
  • 84 Lunetta C, Sansone VA, Penco S. , et al. Amyotrophic lateral sclerosis in pregnancy is associated with a vascular endothelial growth factor promoter genotype. Eur J Neurol 2014; 21 (04) 594-598
    CrossrefPubMedGoogle Scholar
  • 85 Xiao W, Zhao L, Wang F, Sun H, Wang T, Zhao G. Total intravenous anesthesia without muscle relaxant in a parturient with amyotrophic lateral sclerosis undergoing cesarean section: a case report. J Clin Anesth 2017; 36: 107-109
    CrossrefPubMedGoogle Scholar
  • 86 Rudnik-Schöneborn S, Zerres K. Outcome in pregnancies complicated by myotonic dystrophy: a study of 31 patients and review of the literature. Eur J Obstet Gynecol Reprod Biol 2004; 114 (01) 44-53
    CrossrefPubMedGoogle Scholar
  • 87 Johnson NE, Hung M, Nasser E. , et al. The impact of pregnancy on myotonic dystrophy: a registry-based study. J Neuromuscul Dis 2015; 2 (04) 447-452
    PubMedGoogle Scholar
  • 88 Zaki M, Boyd PA, Impey L, Roberts A, Chamberlain P. Congenital myotonic dystrophy: prenatal ultrasound findings and pregnancy outcome. Ultrasound Obstet Gynecol 2007; 29 (03) 284-288
    PubMedGoogle Scholar
  • 89 Erikson A, Forsberg H, Drugge U, Holmgren G. Outcome of pregnancy in women with myotonic dystrophy and analysis of CTG gene expansion. Acta Paediatr 1995; 84 (04) 416-418
    CrossrefPubMedGoogle Scholar
  • 90 Rudnik-Schöneborn S, Schneider-Gold C, Raabe U, Kress W, Zerres K, Schoser BG. Outcome and effect of pregnancy in myotonic dystrophy type 2. Neurology 2006; 66 (04) 579-580
    CrossrefPubMedGoogle Scholar
  • 91 Mathieu J, Allard P, Gobeil G, Girard M, De Braekeleer M, Bégin P. Anesthetic and surgical complications in 219 cases of myotonic dystrophy. Neurology 1997; 49 (06) 1646-1650
    CrossrefPubMedGoogle Scholar
  • 92 Kakourou G, Dhanjal S, Mamas T. , et al. Preimplantation genetic diagnosis for myotonic dystrophy type 1 in the UK. Neuromuscul Disord 2008; 18 (02) 131-136
    CrossrefPubMedGoogle Scholar
  • 93 Feyereisen E, Amar A, Kerbrat V. , et al. Myotonic dystrophy: does it affect ovarian follicular status and responsiveness to controlled ovarian stimulation?. Hum Reprod 2006; 21 (01) 175-182
    CrossrefPubMedGoogle Scholar
  • 94 Verpoest W, De Rademaeker M, Sermon K. , et al. Real and expected delivery rates of patients with myotonic dystrophy undergoing intracytoplasmic sperm injection and preimplantation genetic diagnosis. Hum Reprod 2008; 23 (07) 1654-1660
    CrossrefPubMedGoogle Scholar
  • 95 Lacomis D, Gonzales JT, Giuliani MJ. Fluctuating clinical myotonia and weakness from Thomsen's disease occurring only during pregnancies. Clin Neurol Neurosurg 1999; 101 (02) 133-136
    CrossrefPubMedGoogle Scholar
  • 96 Basu A, Nishanth P, Ifaturoti O. Pregnancy in women with myotonia congenita. Int J Gynaecol Obstet 2009; 106 (01) 62-63
    CrossrefPubMedGoogle Scholar
  • 97 Gorthi S, Radbourne S, Drury N, Rajagopalan C. Management of pregnancy with Thomsen's disease. Eur J Obstet Gynecol Reprod Biol 2013; 170 (01) 293-294
    CrossrefPubMedGoogle Scholar
  • 98 Rudnik-Schöneborn S, Witsch-Baumgartner M, Zerres K. Influences of pregnancy on different genetic subtypes of non-dystrophic myotonia and periodic paralysis. Gynecol Obstet Invest 2016; 81 (05) 472-476
    CrossrefPubMedGoogle Scholar
  • 99 Burge JA, Hanna MG, Schorge S. Nongenomic actions of progesterone and 17β-estradiol on the chloride conductance of skeletal muscle. Muscle Nerve 2013; 48 (04) 589-591
    CrossrefPubMedGoogle Scholar
  • 100 Ciafaloni E, Pressman EK, Loi AM. , et al. Pregnancy and birth outcomes in women with facioscapulohumeral muscular dystrophy. Neurology 2006; 67 (10) 1887-1889
    CrossrefPubMedGoogle Scholar
  • 101 Vissing J, Haller RG. The effect of oral sucrose on exercise tolerance in patients with McArdle's disease. N Engl J Med 2003; 349 (26) 2503-2509
    CrossrefPubMedGoogle Scholar
  • 102 Findlay S, Liu D, Rijhsinghani A. Acute compartment syndrome: clinical course and laboratory findings in pregnant patients with McArdle's disease. Pain Med 2014; 15 (03) 481-482
    CrossrefPubMedGoogle Scholar
  • 103 Giles W, Maher C. Myophosphorylase deficiency (McArdle disease) in a patient with normal pregnancy and normal pregnancy outcome. Obstet Med 2011; 4 (03) 120-121
    CrossrefPubMedGoogle Scholar
  • 104 Kłos J, Kwaśniak-Butowska M, Sławek J. Alglucosidase alfa therapy for Pompe disease in pregnancy – case report. J Neurol Sci 2017; 375: 167-169
    CrossrefPubMedGoogle Scholar
  • 105 de Vries JM, Brugma JD, Ozkan L. , et al. First experience with enzyme replacement therapy during pregnancy and lactation in Pompe disease. Mol Genet Metab 2011; 104 (04) 552-555
    CrossrefPubMedGoogle Scholar
  • 106 Zagnoli F, Leblanc A, Blanchard C. Pregnancy during enzyme replacement therapy for late-onset acid maltase deficiency. Neuromuscul Disord 2013; 23 (02) 180-181
    CrossrefPubMedGoogle Scholar
  • 107 Sánchez MV, Romero R. Acute pulmonary edema secondary to pregnancy in a patient with the mitochondrial disease MELAS. Rev Esp Cardiol 2010; 63 (05) 615-617
    CrossrefPubMedGoogle Scholar
  • 108 Yanagawa T, Sakaguchi H, Nakao T. , et al. Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes with deterioration during pregnancy. Intern Med 1998; 37 (09) 780-783
    CrossrefPubMedGoogle Scholar
  • 109 de Laat P, Fleuren LH, Bekker MN, Smeitink JA, Janssen MC. Obstetric complications in carriers of the m.3243A>G mutation, a retrospective cohort study on maternal and fetal outcome. Mitochondrion 2015; 25: 98-103
    CrossrefPubMedGoogle Scholar
  • 110 Maurtua M, Torres A, Ibarra V, DeBoer G, Dolak J. Anesthetic management of an obstetric patient with MELAS syndrome: case report and literature review. Int J Obstet Anesth 2008; 17 (04) 370-373
    CrossrefPubMedGoogle Scholar
  • 111 Pinheiro GdaR, Goldenberg J, Atra E, Pereira RB, Camano L, Schmidt B. Juvenile dermatomyositis and pregnancy: report and literature review. J Rheumatol 1992; 19 (11) 1798-1801
    PubMedGoogle Scholar
  • 112 Pinal-Fernandez I, Selva-O'Callaghan A, Fernandez-Codina A. , et al. “Pregnancy in adult-onset idiopathic inflammatory myopathy”: report from a cohort of myositis patients from a single center. Semin Arthritis Rheum 2014; 44 (02) 234-240
    CrossrefPubMedGoogle Scholar
  • 113 Váncsa A, Ponyi A, Constantin T, Zeher M, Dankó K. Pregnancy outcome in idiopathic inflammatory myopathy. Rheumatol Int 2007; 27 (05) 435-439
    CrossrefPubMedGoogle Scholar
  • 114 Silva CA, Sultan SM, Isenberg DA. Pregnancy outcome in adult-onset idiopathic inflammatory myopathy. Rheumatology (Oxford) 2003; 42 (10) 1168-1172
    CrossrefPubMedGoogle Scholar
  • 115 Zhong Z, Lin F, Yang J, Zhang F, Zeng X, You X. Pregnancy in polymyositis or dermatomyositis: retrospective results from a tertiary centre in China. Rheumatology (Oxford) 2017; 56 (08) 1272-1275
    CrossrefPubMedGoogle Scholar
  • 116 Akalin T, Akkaya H, Büke B, Koçak İ. A case of new-onset dermatomyositis in the second trimester of pregnancy: a case report and review of the literature. Case Rep Obstet Gynecol 2016; 2016: 6430156
    PubMedGoogle Scholar
  • 117 Linardaki G, Cherouvim E, Goni G, Boki KA. Intravenous immunoglobulin treatment for pregnancy-associated dermatomyositis. Rheumatol Int 2011; 31 (01) 113-115
    CrossrefPubMedGoogle Scholar
  • 118 Nozaki Y, Ikoma S, Funauchi M, Kinoshita K. Respiratory muscle weakness with dermatomyositis during pregnancy: successful treatment with intravenous immunoglobulin therapy. J Rheumatol 2008; 35 (11) 2289
    PubMedGoogle Scholar
  • 119 Norwood F, Rudnik-Schöneborn S. 179th ENMC international workshop: pregnancy in women with neuromuscular disorders 5–7 November 2010, Naarden, The Netherlands. Neuromuscul Disord 2012; 22 (02) 183-190
    CrossrefPubMedGoogle Scholar