[Pubmed] Management of Pregnancy Due to Concern for Preeclampsia in a Woman with Myasthenia Gravis, Chronic Hypertension

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Harefuah. 2026 Apr;165(4):221-224.

ABSTRACT

Myasthenia gravis (MG) is an autoimmune disease impairing neuromuscular ‎transmission due to antibodies against acetylcholine receptors. Preeclampsia is a ‎pregnancy-specific hypertensive disorder that can lead to seizures and cerebral ‎complications, typically prevented with IV magnesium sulfate.‎ In MG patients, magnesium is contraindicated as it inhibits acetylcholine release, ‎worsening muscle weakness and risking respiratory failure.‎ We present a pregnant MG patient with additional preeclampsia risk factors: nulliparity, ‎age, epilepsy, gestational diabetes and chronic hypertension. Due to limited literature, a tailored protocol ‎was created including instructions to:‎ avoid magnesium; use levetiracetam or diazepam for seizures;‎ control blood pressure with hydralazine; add labetalol if needed; Cesarean only for obstetric reasons and to ensure team awareness and minimize stress.‎ This case emphasizes the need for individualized care in high-risk pregnancies with MG.

PMID:41972441


Source: https://pubmed.ncbi.nlm.nih.gov/4197244 ... t6+133c1fe