Atakan Tanacan1, Erdem Fadiloglu2, Gonca Ozten2, Ali Can Gunes2, Gokcen Orgul2, Mehmet Sinan Beksac2. 1. Division of Perinatology, Department of Obstetrics and Gynecology, Hacettepe University Medical Faculty, Sıhhiye, Ankara, Turkey. atakantanacan@yahoo.com. 2. Division of Perinatology, Department of Obstetrics and Gynecology, Hacettepe University Medical Faculty, Sıhhiye, Ankara, Turkey.
Abstract
BACKGROUND AND AIM: To share our experience with the management of pregnancies in women with myasthenia gravis (MG) in a tertiary center. METHODS: The study retrospectively evaluated 27 pregnancies in 12 patients. The pregnancies were divided into 3 groups on the basis of the clinical course of MG during pregnancy: improvement (n = 7), disease-stable (n = 9), and deterioration (n = 11). The groups were compared with respect to patient characteristics, clinical features, and obstetric outcomes. RESULTS: There were 4 miscarriages (14.8%), 3 preterm births (11.1%), and 4 cases of preterm premature rupture of the membranes (PPROM) (14.8%). Exacerbation was observed in 25.9% of the cases; the remission rate during the postpartum period and after miscarriage was 37%. The cesarean section (CS) rate was 78.3%. Pregnancies with deterioration of MG were statistically more likely to have higher miscarriage, preterm birth, PPROM, CS, and transient neonatal MG rates, in addition to a lower gestational age at birth, birth weight, and 5-min Apgar score than pregnancies with improved or stable disease (p values < 0.001, 0.04, 0.03, 0.009, 0.02, < 0.001, 0.002, and 0.043, respectively). CONCLUSION: Physicians who manage pregnant women with MG must be familiar with the clinical features of the condition; a multidisciplinary approach is necessary for a better prognosis.
BACKGROUND AND AIM: To share our experience with the management of pregnancies in women with myasthenia gravis (MG) in a tertiary center. METHODS: The study retrospectively evaluated 27 pregnancies in 12 patients. The pregnancies were divided into 3 groups on the basis of the clinical course of MG during pregnancy: improvement (n = 7), disease-stable (n = 9), and deterioration (n = 11). The groups were compared with respect to patient characteristics, clinical features, and obstetric outcomes. RESULTS: There were 4 miscarriages (14.8%), 3 preterm births (11.1%), and 4 cases of preterm premature rupture of the membranes (PPROM) (14.8%). Exacerbation was observed in 25.9% of the cases; the remission rate during the postpartum period and after miscarriage was 37%. The cesarean section (CS) rate was 78.3%. Pregnancies with deterioration of MG were statistically more likely to have higher miscarriage, preterm birth, PPROM, CS, and transient neonatal MG rates, in addition to a lower gestational age at birth, birth weight, and 5-min Apgar score than pregnancies with improved or stable disease (p values < 0.001, 0.04, 0.03, 0.009, 0.02, < 0.001, 0.002, and 0.043, respectively). CONCLUSION: Physicians who manage pregnant women with MG must be familiar with the clinical features of the condition; a multidisciplinary approach is necessary for a better prognosis.
Authors: C Ramirez; J de Seze; O Delrieu; T Stojkovic; S Delalande; F Fourrier; D Leys; L Defebvre; A Destée; P Vermersch Journal: Rev Neurol (Paris) Date: 2006-03 Impact factor: 2.607
Authors: Donald B Sanders; Gil I Wolfe; Michael Benatar; Amelia Evoli; Nils E Gilhus; Isabel Illa; Nancy Kuntz; Janice M Massey; Arthur Melms; Hiroyuki Murai; Michael Nicolle; Jacqueline Palace; David P Richman; Jan Verschuuren; Pushpa Narayanaswami Journal: Neurology Date: 2016-06-29 Impact factor: 9.910
Authors: Kemal Beksaç; Gökçen Örgül; Murat Çağan; Ergun Karaağaoğlu; Serap Arslan; Mehmet Sinan Beksaç Journal: J Turk Ger Gynecol Assoc Date: 2017-03-15