Miastenia Gravis: Embarazo E Impacto Perinatal

P, Ernesto Perucca; J, Eduardo Cuellar; A, Paolo Ricci; A, Roberto Altamirano; C, Carlos Cuadra; M, David Sáez; G, Rodrigo Carvajal; F, Isabel Galleguillos; Q, Muschi Szigethi; Álvarez, Sergio A.; R, Norman Agurto; F, Jessica Zamora

doi:10.4067/s0717-75262006000300010

Cited by 5 publications

(8 citation statements)

References 11 publications

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“…La MG, enfermedad que aparece preferentemente en mujeres (65-70% de los casos), y particularmente en aquellas en edad fértil 40 , lo que la hace una patología relativamente frecuente de encontrar asociada al embarazo.…”

Section: Miastenia Gravis (Mg)unclassified

“…La infl uencia de la gestación sobre la patología es impredecible, los diferentes trabajos demuestran que los grupos de pacientes que empeoran, mejoran o se mantienen sin variación durante el embarazo son iguales 1,28,40 . En Chile, el grupo de mujeres que empeoran parece ser menor 40 . Se ha descrito además que el riesgo de crisis durante el embarazo aumenta si la gestación aparece al año del diagnóstico 10 , y dentro del embarazo los momentos más críticos son el tercer trimestre y el período post parto debido probablemente a la caída de la alfa-fetoproteína 28 .…”

Section: Miastenia Gravis (Mg)unclassified

“…Algunos autores recomiendan suspender la lactancia materna en mujeres que presentan una exacerbación post-parto; pues los anticuerpos pasan al niño a través de la leche materna pero no así los anticolinesterásicos. En el grupo de Perucca se describen tres muertes neonatales por MG neonatal 40 .…”

Section: Miastenia Gravis (Mg)unclassified

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Neurología y embarazo

2010

Rev. chil. neuro-psiquiatr.

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Pregnancy produces a series of physiological changes in women which may trigger several neurologic pathologies or decompensation in pre-existing diseases. There are neurologic complications in pathological pregnancies such as: Wernicke's encephalopathy; posterior reversible encephalopathy which is a form of eclampsia; previous diseases such as epilepsies that entail a high obstetric risk due to the possibility of presenting embriopathies associated to the use of antiepileptic drugs (AEDs) and also because of the risk of a convulsive crisis in the fetus; cerebrovascular diseases which are rare although with high maternal mortality; extrapyramidal pathologies which are infrequent except for the chorea gravidarum and the restless legs syndrome; cerebral neoplasms in which due to haemodynamic changes at the end of the second quarter and the increase of estrogen and progesterone many tumors may raise their volume; and peripheral alterations like myasthenia gravis (MG); intervertebral disk displacement and entrapment neuropathies like carpal tunnel syndrome and meralgia paresthetica. Anyhow because of cellular immunity in multiple sclerosis pregnancy is protected from new outbreaks.

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Section: Miastenia Gravis (Mg)unclassified

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Neurología y embarazo

2010

Rev. chil. neuro-psiquiatr.

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“…Previous studies report exacerbation rates on the order of 30% 6,7 though higher 8,9 and lower 10 rates have been reported. The literature is similarly discordant in regards to pregnancy outcome, with some studies reporting increased rates of preterm prelabour rupture of membranes (PPROM), preterm birth (PTB), small for gestational age (SGA) babies and caesarean delivery 11,12 , and others reporting rates similar to that of the general population 13,14 . Transient neonatal myasthenia gravis (TNMG) is a complication whereby the AChR autoantibodies pass through the placenta causing a self-limited myasthenic syndrome in the neonate.…”

Section: Introductionmentioning

confidence: 99%

Myasthenia Gravis in Pregnancy: Case Series and Systematic Review

Banner¹,

Niles²,

Ryu³

et al. 2020

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Background: Myasthenia gravis (MG) is an autoimmune disease which can affect reproductive-aged women and impact pregnancy outcomes. Objectives: To systematically review pregnancy outcomes for patients with MG. Search Strategy: Ovid MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, PubMed (Non-Medline records), Web of Science, and LILACS databases were systematically searched for pregnancies complicated by MG. Selection Criteria: Human studies of five or more subjects reporting outcomes of MG in pregnancy published in any language. Data Collection and Analysis: Following identification and review of relevant studies, data on study characteristics, MG subtypes, treatment, disease and pregnancy outcomes were extracted. Assessment of bias was performed using the National Institutes of Health Quality Assessment Tool for Case Series. In addition, cases of MG in pregnancy managed at our centre were identified and outcomes included in the analysis. Main Results: In total, 32 publications met inclusion criteria for systematic review, for a total of 33 unique data sets including 48 cases at our institution. In total, outcome data was available for 824 pregnancies complicated by MG. Overall risk of MG exacerbation was 33.8% with a 6.4% risk of myasthenic crisis in pregnancy and 8.2% postpartum. Spontaneous vaginal delivery occurred in 56.3% of pregnancies. The risk of transient neonatal myasthenia gravis (TNMG) was 13.0%. Conclusions: One third of pregnant MG patients will experience an exacerbation with 6.4% and 8.2% experiencing myasthenic crisis in pregnancy and postpartum respectively. More than half of MG patients had a spontaneous vaginal birth. The risk of TNMG is 13%

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