- What to do during pregnancy
- What care to take during childbirth
- Can the mother breastfeed?
- Can the disease pass to the baby?
Myasthenia Gravis is an autoimmune disease that causes progressive muscle weakness and generally appears between the ages of 20 and 40, and symptoms gradually appear and worsen, although in some cases they can start suddenly. Find out everything about this disease.
Pregnancy in a woman with Myasthenia Gravis can become a risky situation for the mother and the fetus, and although there are cases in which the baby is born healthy, there are others in which the disease worsens and therefore monitoring is very important. frequent pregnancy.
The most common symptoms are muscle weakness and fatigue during pregnancy, with childbirth being the most dangerous moment of the entire pregnancy.
What to do during pregnancy
It is recommended that, after diagnosing the disease, the woman wait at least 2 years before becoming pregnant, as the risk of death of the mother during pregnancy is much higher during the first year of the disease.
The treatment for Myasthenia Gravis in pregnant women should be the same as they did before becoming pregnant and adequate monitoring should be carried out throughout the gestational period.
What care to take during childbirth
If there are no signs of fetal distress or any obstetric problem, delivery can be performed vaginally, however, due to the risk of muscle fatigue, there may be difficulty on the part of the mother in voluntary force at the time of expulsion of the fetus and therefore forceps or obstetric pullers may be required to remove the baby and reduce labor time.
Cesarean section should only be performed if there is an indication by the doctor who accompanied the pregnant woman in cases of more severe Myasthenia Gravis or myasthenic crisis. If there is respiratory or bulbar muscle involvement, general anesthesia with orotracheal intubation is recommended, in order to be able to control oxygenation and secretions.
In the postpartum period, it is very important to keep an eye on the mother, as there is a risk of the disease getting worse in the 3 weeks following the baby's birth.
Can the mother breastfeed?
Breastfeeding is not contraindicated in myasthenic women, however it is not recommended during treatment with immunosuppressants such as azathioprine, cyclosporine, cyclophosphamide, mycophenolate or methotrexate.
There are also studies that indicate that breastfeeding of newborns should be avoided, since antibodies are found in breast milk that can intensify neonatal Myasthenia Gravis, which ends up disappearing about 3 weeks after birth.
Thus, it is important for the mother to discuss with the doctor the benefits of breastfeeding in view of the risks.
Can the disease pass to the baby?
Despite the antibodies that cause this disease to cross the placenta, only 20% of newborns born to mothers with Myasthenia Gravis during pregnancy present the disease at birth and, when they do, it tends to disappear a few days or weeks after birth, because the maternal antibodies eventually disappear and the newborn does not produce antibodies of this type.
