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A national UK workshop to discuss practical clinical management issues related to pregnancy in women with myasthenia gravis was held in May 2011. The purpose was to develop recommendations to guide general neurologists and obstetricians and facilitate best practice before, during and after pregnancy. The main conclusions were (1) planning should be instituted well in advance of any potential pregnancy to allow time for myasthenic status and drug optimization; (2) multidisciplinary liaison through the involvement of relevant specialists should occur throughout pregnancy, during delivery and in the neonatal period; (3) provided that their myasthenia is under good control before pregnancy, the majority of women can be reassured that it will remain stable throughout pregnancy and the postpartum months; (4) spontaneous vaginal delivery should be the aim and actively encouraged; (5) those with severe myasthenic weakness need careful, multidisciplinary management with prompt access to specialist advice and facilities; (6) newborn babies born to myasthenic mothers are at risk of transient myasthenic weakness, even if the mother?s myasthenia is well-controlled, and should have rapid access to neonatal high-dependency support. |
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adverse drug reaction
arthrogryposis multiplex
congenital myasthenic syndromes
delivery,complicated
myasthenia gravis
myasthenia gravis,neonatal
myasthenia gravis,treatment of
mycophenolate
newborn,evaluation of
postpartum
practice guidelines
pregnancy,neurologic complications in
review article
safety
treatment of neurologic disorder
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