Management of labor and delivery in myasthenia gravis: A new protocol

The Journal of Obstetrics and Gynaecology Research
Kotoi TsuraneAkira Kohyama

Abstract

Pregnancy with myasthenia gravis (MG) is known to be associated with an increased cesarean section rate, presumably due to maternal fatigue during labor. Although epidural labor analgesia (ELA) appears to be a good option for circumventing maternal fatigue, a protocol for managing MG deliveries has not been established. This study, based on a review of our case series, aimed to evaluate the validity of our management protocol for maternal MG, in which ELA is used depending on MG severity. Parturients with systemic muscle weakness or worsening symptoms were classified as Category A (A), and those without symptoms were classified as Category B (B). In A, ELA was given at the onset of labor. Immediate vacuum delivery was done once the fetal head descended to station +2. For B, spontaneous vaginal delivery was chosen. The duration, blood loss, fetal weight, Apgar score and MG symptoms on post-partum day (PPD) 1, 14 and 30 were recorded. Six patients were enrolled. Four were classified in A, and two were classified in B. No adverse events occurred during labor. Transvaginal delivery was successfully achieved in all the patients. Symptoms of MG were well-controlled. MG symptoms were stable on PPD 1 in all the patients although two pa...Continue Reading

References

Feb 20, 1999·Neurology·A P BatocchiP Tonali
May 5, 1999·Neurology·G I WolfeR J Barohn
Jul 20, 2002·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Josip DjelmisMarina Ivanisevic
Nov 26, 2003·Neurology·Jana Midelfart HoffNils Erik Gilhus
Aug 2, 2005·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Simone FerreroNicola Ragni
Jan 16, 2007·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·J M HoffN E Gilhus
Aug 13, 2008·Muscle & Nerve·Larry L MullinsUNKNOWN Muscle Study Group
Jun 3, 2009·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·J-C WenW-C Tsai
Aug 25, 2010·European Journal of Anaesthesiology·Carlos AlmeidaJosé Aguiar
Mar 2, 2016·Muscle & Nerve·António Costa BragaJorge Braga
Mar 4, 2017·Neuromuscular Disorders : NMD·Renata D DucciRosana H Scola
Oct 25, 2017·Sultan Qaboos University Medical Journal·Ali Hassan, Zakia M Yasawy

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Citations

Jul 26, 2019·Journal of Medical Ethics·Nick Colgrove
Aug 1, 2020·Frontiers in Neurology·Maria Elena Farrugia, John A Goodfellow
Jul 1, 2020·Frontiers in Neurology·Nils Erik Gilhus
Aug 3, 2020·Journal of Perinatal Medicine·Laura Nicholls-DempseyHaim Arie Abenhaim
Mar 3, 2021·Revue neurologique·P Roche, F Bouhour
Jun 29, 2021·Current Treatment Options in Neurology·Deepa MalaiyandiKristin Guilliams
Jul 22, 2021·Arquivos de neuro-psiquiatria·Renata Dal-Prá DucciRosana Herminia Scola

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