RT Journal Article
SR Electronic
T1 Myasthenia in pregnancy: best practice guidelines from a UK multispecialty working group
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 538
OP 543
DO 10.1136/jnnp-2013-305572
VO 85
IS 5
A1 Fiona Norwood
A1 Mandish Dhanjal
A1 Marguerite Hill
A1 Natalie James
A1 Heinz Jungbluth
A1 Pippa Kyle
A1 Geraldine O'Sullivan
A1 Jacqueline Palace
A1 Stephanie Robb
A1 Catherine Williamson
A1 David Hilton-Jones
A1 Catherine Nelson-Piercy
YR 2014
UL http://jnnp.bmj.com/content/85/5/538.abstract
AB A national UK workshop to discuss practical clinical management issues related to pregnancy in women with myasthenia gravis was held in May 2011. The purpose was to develop recommendations to guide general neurologists and obstetricians and facilitate best practice before, during and after pregnancy. The main conclusions were (1) planning should be instituted well in advance of any potential pregnancy to allow time for myasthenic status and drug optimisation; (2) multidisciplinary liaison through the involvement of relevant specialists should occur throughout pregnancy, during delivery and in the neonatal period; (3) provided that their myasthenia is under good control before pregnancy, the majority of women can be reassured that it will remain stable throughout pregnancy and the postpartum months; (4) spontaneous vaginal delivery should be the aim and actively encouraged; (5) those with severe myasthenic weakness need careful, multidisciplinary management with prompt access to specialist advice and facilities; (6) newborn babies born to myasthenic mothers are at risk of transient myasthenic weakness, even if the mother's myasthenia is well-controlled, and should have rapid access to neonatal high-dependency support.