Guillain–Barre syndrome in pregnancy and its association with maternal and perinatal outcome

Abstract

Background: Guillain–Barre syndrome or acute inflammatory demyelinating proliferative syndrome is rare in pregnancy. It affects the nervous system, presenting as an acute onset of symmetric ascending weakness resulting in respiratory failure and autonomic dysfunction. Aims: This study aims to study the incidence of GBS in pregnant women and its association with maternal and perinatal outcome. Settings and Design: Retrospective observational study conducted at a tertiary care hospital. Materials and Methods: Records of all women diagnosed as GBS in pregnancy and postpartum period were analyzed. Maternal and perinatal outcomes were studied based on the pattern of involvement of limbs, need for ventilator support, treatment with plasmapheresis and intravenous immunoglobulin (IVIG), intrauterine fetal demise (IUFD), and neonatal deaths. Results: During the study of 3 years, there were 11,484 deliveries, of which 8 women had GBS. The incidence of GBS was 0.06%. Lower limb weakness developed in 6 (75%) of women, bifacial weakness in 2 (25%), IVIG received by 3 (37.5%), and (62.5%) underwent plasmapheresis. Four (50%) required ventilator support and maternal mortality was recorded in 2 (25%) due to respiratory failure and IUFD in 2 (25%) of women. Conclusions: GBS is associated with high maternal and perinatal morbidity. Timely diagnosis by obstetricians and management in women complaining of muscular weakness and respiratory difficulty in pregnancy and early postpartum period will help in improving the maternal and perinatal outcome.

Keywords

• immunoglobulins
• neuropathy
• paraesthesia
• plasmapheresis
• syndrome