Researchers from Australia reported the rare case of a woman who was diagnosed with myasthenia gravis (MG) in the third trimester of her pregnancy.
“This case outlines the rare occurrence of a new diagnosis of MG in pregnancy, and the complexities in management,” the researchers wrote in a report they published in Case Reports in Women’s Health. The case highlighted the importance of a collaborative approach in decision making about the timing and method of delivery to achieve the best outcome for both the mother and the baby.
Read more about the complications of MG
The case presented here is that of a 25-year-old female who was in her first pregnancy. She did not have any significant medical history, and she presented for her routine antenatal appointment at 37 weeks.
She said that she had been having double vision for the previous 2 weeks and weakness in her proximal limbs that came and went for the last 5 months.
A neurological examination revealed right upper limb flaccidity and arm and leg weakness on both sides, which was more severe in the arms and the proximal muscles. The nerves in her eyes showed mild restriction in all directions.
The patient was investigated with spirometry, brain and spine magnetic resonance imaging, and needle electromyography, which led to a diagnosis of anti-muscle-specific tyrosine kinase antibody-positive MG.
The potential complications of her disease included myasthenic crisis, complications during delivery, and transient MG in the baby.
The patient was treated with plasmapheresis and prednisone for 5 days, and she underwent an elective caesarean section because of frequent changing in fetal lie at week 39 of her pregnancy.
No complications occurred during the delivery, and she delivered a healthy boy, who was monitored for 4 days without any signs of MG.
Aitken A, Kanitkar S. New diagnosis of myasthenia gravis in the third trimester – a case report. Case Rep Womens Health. Published online April 1, 2023. doi:10.1016/j.crwh.2023.e00505