Мyasthenia gravis and pregnancy: overview of the problem

Taking into account the fairly widespread prevalence of myasthenia among women and the fact that myasthenia does not affect fertility, the possibility of manifestation of the disease in reproductive age cannot be excluded. This necessitates the study of the clinical course of myasthenia during pregnancy and the provision of adequate attention to an adequate selection of therapy. The article presents epidemiological and etiological data, illustrates and describes key aspects of pathogenesis of myasthenia. The patterns of manifestation of myasthenia during pregnancy and the effect of the disease on the course of pregnancy are given. The dependence of the severity of symptoms of myasthenia on the trimester of pregnancy is analyzed. Emphasis is placed on the relationship of the presented patterns with the immunological characteristics of the woman’s body in different periods of pregnancy, these features are also considered in the postpartum period. The specificity of the process of childbirth in women with myasthenia is described, the probability of spontaneous termination of pregnancy, the occurrence of difficulties during childbirth and the possibility of identifying and patterns in the formation of transient neonatal myasthenia of the fetus are considered.The issue of the safety of spinal and epidural anesthesia in the process of delivery is raised. Mandatory diagnostic procedures for making a diagnosis of myasthenia during pregnancy are highlighted. Emphasis is placed on the role of the importance of analyzing the methods of treatment of this disease, and also presents the results of studies devoted to the study of this problem. The role of thymectomy and the effect of this surgical method of treatment on the course of the disease in terms of pregnancy are indicated. It has been shown that predicting the manifestation of the disease during pregnancy is difficult, however, the pregnancy can be completed safely and, most importantly, myasthenia itself is not an absolute contraindication to pregnancy.

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