Pregnancy with myasthenia gravis

Abstract

Myasthenia gravis (MG) is an autoimmune disorder of the neuromuscular transmission, caused by auto antibodies against the nicotinic acetylcholine receptor. These antibodies of the IgG isotype are detected in 80-90% of generalized MG and in 50-70% of ocular MG. Seronegative MG is caused by humoral factors. Prevalence of MG lies between 1 in 10.000 and 1 in 50.000, with 2/3 of affected individuals being female. In the case of maternal myasthenia gravis, both the mother and the child may develop myasthenia symptoms with varying degrees of weakness and progressive fatigability of the skeletal muscles. Data for the case report were generated by reviewing labour, delivery, and postpartal records. We present a 26 years old lady who suffered from a generalized form of myasthenia gravis since the age of 15. She got herself admitted to a neurologic clinic for a myasthenic crisis when she was two and half months pregnant. The patient was treated with anticholinesterase medication, corticosteroids and intravenous immunoglobulin. Clinically, the patient's condition improved significantly during pregnancy. Delivery and the post delivery period were also normal for the patient. Myasthenia gravis especially when associated with pregnancy is a high-risk disease. As this disease predominantly occurs in women of reproductive age, it is important to be aware of this condition in obstetrics and its interdisciplinary diagnostic and therapeutic management is required.