Myasthenia in pregnancy: best practice guidelines from a UK multispecialty working group

Fiona Norwood; Mandish Dhanjal; Marguerite Hill; Natalie James; Heinz Jungbluth; Pippa Kyle; Geraldine O'Sullivan; Jacqueline Palace; Stephanie Robb; Catherine Williamson; David Hilton-Jones; Catherine Nelson-Piercy

doi:10.1136/jnnp-2013-305572

Myasthenia in pregnancy: best practice guidelines from a UK multispecialty working group

Fiona Norwood^*, Mandish Dhanjal, Marguerite Hill, Natalie James, Heinz Jungbluth, Pippa Kyle, Geraldine O'Sullivan, Jacqueline Palace, Stephanie Robb, Catherine Williamson, David Hilton-Jones, Catherine Nelson-Piercy

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

123 Citations (Scopus)

Abstract

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.

Original language	English
Pages (from-to)	538-543
Number of pages	6
Journal	Journal of Neurology, Neurosurgery and Psychiatry
Volume	85
Issue number	5
DOIs	https://doi.org/10.1136/jnnp-2013-305572
Publication status	Published - May 2014

Keywords

RECEPTOR INACTIVATION SYNDROME
TRANSPLANT RECIPIENTS
GRAVIS
EXPOSURE
OUTCOMES
WOMEN
BIRTH
CORTICOSTEROIDS
AUTOANTIBODIES
METAANALYSIS

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title = "Myasthenia in pregnancy: best practice guidelines from a UK multispecialty working group",

abstract = "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.",

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author = "Fiona Norwood and Mandish Dhanjal and Marguerite Hill and Natalie James and Heinz Jungbluth and Pippa Kyle and Geraldine O'Sullivan and Jacqueline Palace and Stephanie Robb and Catherine Williamson and David Hilton-Jones and Catherine Nelson-Piercy",

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AU - Kyle, Pippa

AU - O'Sullivan, Geraldine

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AU - Williamson, Catherine

AU - Hilton-Jones, David

AU - Nelson-Piercy, Catherine

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KW - CORTICOSTEROIDS

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KW - METAANALYSIS

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ER -

Myasthenia in pregnancy: best practice guidelines from a UK multispecialty working group

Abstract

Keywords

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