Implications and clinical management of myasthenia gravis during pregnancy

Abstract

Myasthenia gravis (MG) is an autoimmune disorder defined by weakness and rapid fatigue of skeletal muscles due to deterioration of neuromuscular junction by autoantibodies targeting either acetylcholine receptors (AchRs) or other molecules such as muscle specific kinase receptors (MuSK). It affects predominantly women in the third decade of life and the effects of pregnancy on the evolution of the disease is variable, usually the aggravation of symptoms occurs during the first trimester or first month postpartum. The aim of this review is to discuss the clinical management of MG in pregnancy and to highlight the implications of MG on pregnancy and vice-versa, as well as reviewing the available treatment by using documentary analysis. The findings of this review show a variable clinical course of the disease with remission, worsening or preserving the status quo. MG does not influence the course of pregnancy to a large degree and by careful antenatal care and a multidisciplinary team approach a normal pregnancy and delivery can be achieved.

Keywords

• myasthenia gravis
• pregnancy
• weakness
• acetylcholinesterase inhibitors