• Expert Rev Neurother · Jun 2008

    Review

    Myasthenia gravis during pregnancy.

    • Simone Ferrero, Francesca Esposito, Mariangela Biamonti, Giorgio Bentivoglio, and Nicola Ragni.
    • Department of Obstetrics & Gynecology, San Martino Hospital & University of Genoa, Largo R. Benzi 1, 16132, Genoa, Italy. dr@simoneferrero.com
    • Expert Rev Neurother. 2008 Jun 1;8(6):979-88.

    AbstractMyasthenia gravis (MG) affects women in the second and third decades of life, overlapping with the childbearing years. During pregnancy, the course of this disease is unpredictable; worsening of symptoms occurs more likely during the first half of pregnancy and postpartum. MG can be well managed during pregnancy with relatively safe and effective therapies. Cesarean section is recommended only for obstetric reasons; epidural anesthesia is advised to reduce physical and emotional stress. Anticholinesterase drugs are the mainstay of treatment, when MG symptoms are not satisfactorily controlled, corticosteroids, azathioprine and in some cases cyclosporin A may be used. Life-threatening conditions (e.g., respiratory insufficiency) may occur during pregnancy; therefore, intensive check-ups by a gynecologist and a neurologist are necessary.

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