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Neuromuscular Diseases: Myasthenia Gravis, Spinal Muscular Atrophy, Nondystrophic Myotonias, and Muscular Dystrophies 

Neuromuscular Diseases: Myasthenia Gravis, Spinal Muscular Atrophy, Nondystrophic Myotonias, and Muscular Dystrophies
Chapter:
Neuromuscular Diseases: Myasthenia Gravis, Spinal Muscular Atrophy, Nondystrophic Myotonias, and Muscular Dystrophies
Author(s):

Johanna Hamel

, and Emma Ciafaloni

DOI:
10.1093/med/9780190667351.003.0024
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date: 05 August 2020

Myasthenia gravis is an acquired autoimmune disorder characterized by weakness of skeletal muscle, which often affects women in the childbearing age. A number of questions arise when a woman with myasthenia gravis plans to become pregnant or presents with pregnancy, as myasthenia can affect the pregnancy, delivery and the fetus. In addition, the pregnancy can affect the course of myasthenia and worsening of the disease during pregnancy may require treatment modifications. Therefore supportive counseling, ideally preceding conception, is indicated, focusing on issues of fertility, treatment optimization and drug safety, risks of worsening of symptoms during pregnancy and delivery. Counseling on possible effects on the infant should be discussed, as such as neonatal myasthenia gravis, a treatable and transient disease. Patients with myasthenia gravis may require more intensive monitoring and care, and should be supported by a multidisciplinary team involving the obstetrician, anesthesiologist, and neurologist.

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