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Semin Neurol 2004; 24(1): 95-100
DOI: 10.1055/s-2004-829590
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

The Management of Myasthenia Gravis in Pregnancy

Emma Ciafaloni1 , Janice M. Massey2
  • 1Assistant Professor of Neurology, Department of Neurology, University of Rochester, Rochester, New York
  • 2Professor of Neurology, Department of Medicine, Division of Neurology, Duke University, Durham, North Carolina
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Publication History

Publication Date:
01 July 2004 (online)

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As with several autoimmune diseases, myasthenia gravis (MG) occurs frequently in young women in their childbearing years. The treatment of MG in women therefore poses unique and challenging issues to neurologists, obstetricians, and neonatologists as the safety of both mother and fetus needs to be carefully considered when choosing a therapeutic plan. The severity of generalized weakness and the potential for respiratory insufficiency and myasthenic crises in the mother should dictate how aggressive a treatment plan should be. The potential effects of immunosuppressant medications on the fetus should always be weighed against the risk of myasthenic crises and its potential to endanger both mother and fetus. Successful management of MG during pregnancy and in the postpartum period is possible in many cases but requires collaboration between the obstetrician, the neurologist, and a well-informed patient. The neurologist should be able to counsel women and discuss treatment options and pregnancy risks based on the best current knowledge, so that women will be able to make an informed decision and successfully complete pregnancy.

KEYWORDS

Myasthenia gravis - pregnancy - neonatal myasthenia gravis - acetylcholine receptor antibodies - arthrogryposis

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Emma CiafaloniM.D. 

Assistant Professor of Neurology, Department of Neurology, University of Rochester

601 Elmwood Avenue, Box 673, Rochester, NY 14642

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