Myasthenia gravis in pregnancy – a multidisciplinary approach

Abstract

Myasthenia gravis (MG) is an autoimmune condition that mainly affects young women (in the second or third decade of life) and is characterized by clinical symptoms ranging from fluctuating muscle weakness in the scapular and pelvic girdle to res­piratory, ocular and bulb symptoms. Counseling and preconception planning, the assessment of the impact of pregnancy on the disease, the possible maternal-fetal complications in the first trimester and postpartum, the prophylaxis of myasthenic and cholinergic seizures, the teratogenic potential of medication, the careful fetal monitoring, the intrapartum features of analgesia and anesthesia and the management of neonatal myasthenia gravis are many problems that must be carefully monitored during pregnancy. These goals are achieved through the efforts of a multidisciplinary team. Therefore, women with MG should be supported in their desire to become pregnant and advised to give birth in tertiary medical units that manage high-risk pregnancies and ensure good neonatal intensive care.