Management of pregnancy in myasthenia gravis (MG)
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Management of pregnancy in myasthenia gravis (MG). Plan pregnancy in advance, Consider thymectomy if appropriate. Fully referenced neurology checklist.
Pre-conception management
- Plan pregnancy in advance
- Consider thymectomy if appropriate
Pre-conception assessments
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General management guidelines
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Safe myasthenia medications in pregnancy and breastfeeding
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Contraindicated myasthenia medications in pregnancy and breastfeeding
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Myasthenia medications to be used with caution in pregnancy
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Contraindicated non-myasthenia gravis medications
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Steroid management
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Precautions with plasma exchange (PE) in pregnancy
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Anaesthetic management
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Vaccination schedule
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Monitoring during pregnancy
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Post-delivery management
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Breastfeeding management
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References
- Norwood F, Dhanjal M, Hill M, et al. Myasthenia in pregnancy: best practice guidelines from a UK multispecialty writing group. JNNP 2014; 85:538-543.
- Tellez-Zenteno JF, Hernandez-Ronquillo L, Salinas V, Estanol B, da Silva O. Myasthenia gravis and pregnancy: clinical implications and neonatal outcome. BMC Musculoskelet Disord 2004; 5:42.
- Skeie GO, Apostolski S, Evoli A, et al. Guidelines for treatment of autoimmune neuromuscular transmission disorders. Eur J Neurol 2010; 17:893-902.
- Hoff JM, Daltveit AK, Gilhus N. Myasthenia gravis: consequences for pregnancy, delivery and the newborn. Neurology 2003; 61:1459-1460.
- Gilhus NE. Treatment considerations in myasthenia gravis for the pregnant patient. Expert Rev Neurother 2023; 23:169-177.
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