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VOLUME 55 , ISSUE 4 ( October-December, 2021 ) > List of Articles
Nilofar Noor, Vidushi Kulshrestha, Kallol Kumar Roy, Kandala Aparna Sharma
Keywords : Myasthenia crisis, Myasthenia gravis, Pregnancy, Pyridostigmine
Citation Information : Noor N, Kulshrestha V, Roy KK, Sharma KA. Pregnancy in Post-splenectomized Myasthenia Gravis: A Case Report. J Postgrad Med Edu Res 2021; 55 (4):183-185.
License: CC BY-NC 4.0
Published Online: 29-10-2021
Copyright Statement: Copyright © 2021; The Author(s).
Aim and objective: We aim to emphasize the principles of management of pregnant women with a complex medical condition such as myasthenia gravis. Background: Myasthenia gravis is an autoimmune disorder affecting neuromuscular transmission resulting in fatigable weakness of skeletal muscles. Case description: We report a case of pregnancy with myasthenia gravis with a history of splenectomy. The patient was on oral pyridostigmine and prednisolone, which were continued in pregnancy. The patient received multidisciplinary care involving obstetrician, neurologist, anesthetist, and had an uneventful antenatal course. She had a normal vaginal delivery and her postpartum period was uneventful with neonate not developing any signs of myasthenia. Conclusion: This case highlights the importance of a multidisciplinary approach in managing pregnancy with myasthenia gravis for optimum maternal and neonatal outcomes. The patient should continue the drugs for myasthenia throughout pregnancy. Vaginal delivery is not contraindicated, with preparedness for intubation to tackle myasthenia crisis. Instrumental delivery may be needed for inadequate bearing-down efforts. Neonates should be monitored for 48 hours for transient neonatal myasthenia symptoms and may need pyridostigmine till symptoms resolve. Clinical significance: Autoimmune conditions like myasthenia gravis are not uncommon in women in the reproductive age-group. Hence, obstetricians need to acquaint themselves with the knowledge to ensure early diagnosis and appropriate management for a safe pregnancy outcome.
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