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Myasthenia Problems During Pregnancy and Birth

An improvement of the Myasthenia Gravis is just as possible during the pregnancy as a degradation. Mestinon or Kalymin cannot be taken without hesitation, them represent for the unborn a risk. Cortisone is regarded as relatively safe medicine during the pregnancy and is probably the means of first choice, if a Immunosuppression is necessary during the pregnancy. Immunglobuline, immune adsorption and Plasmapheresis are likewise without special risk for the pregnancy. The risk of premature baby birth should be increased with Myasthenia mothers.

The myasthenia pregnant woman should use to gather strength for the birth and not least for a very stressful time after birth. A stable Myasthenia is during the pregnancy meaningfully and importantly also for the child.

Because the muscles of the uterus are not affected by the MG Myasthenia Gravis, a normal birth is possible in principle. Only in the second stage of other muscles is required to cooperate, they are too weak, the use of ventouse or forceps be useful. With the exhaustion of a Caesar child birth may be necessary, but this is rather the exception. That are absolutely necessary precautions anaesthesia or local anaesthesia should definitely be discussed long before the birth with the doctors.

Since during the birth, the digestive processes are interrupted, and the active ingredients from tablets at that time only partly absorbed by the body. Mestinon should be injected intravenously if needed.

From 15 to 30 percent of the infant born children of myasthenic mg myasthenia mothers has a so-called neonatale myasthenia gravis (neonatal MG), which heals completely however within fewer weeks of after the birth. The symptoms arise within a few days after the birth and show up particularly in weakness when drinking and crying. Which children are concerned, cannot be predicted unfortunately and is not from the condition and the anti-body titer of the mother to be derived. Each newborn child of a mg mother should be supervised therefore some days after the birth medically. Also the freshly baked mother should observe herself carefully, because the hormone conversion after the birth can cause a degradation of the Myasthenia with approximately 30% of the women. For these reasons it is very advisable to go for relieving into a hospital with attached newborn child monitoring station and myasthenie experienced neurology.

It is to be considered, medicines into the mother’s milk ignores. With Mestinon one goes out in the meantime with it, mixing to 300 mg with a satisfying mother is harmless. But not only medicines, but also the antibodies of the mother are to be found in the milk. Whether satisfying is justifiable is very controversially discussed, from there and should be decided in individual cases in each case.

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Myasthenic Woman Should Be Aware Before Pregnant

The Myasthenia no obstacle for a pregnancy. The MG (Myasthenia Gravis) one does not further-leave, and the muscles of the uterus are not affected by the myasthenia. Nevertheless some things are to be considered approximately around the pregnancy. Pregnancies with Myasthenia Gravis woman must be regarded in principle as risk pregnancies, a good co-operation between the woman, the treating neurologist and the gynecologist are very important!

Which should be considered before the pregnancy, depends naturally completely considerably on how heavy the Myasthenia is and is taken which medicines. Who comes only with Mestinon marvelously by right or without medicines, needs itself before not too many thoughts to make.

Differently it looks, if immunosuppressive  are necessary or meaningful. In principle it is not naturally better, in these times children too gotten, because these medicines can cause – at least theoretically – damage with the child. Before now the immunosuppressive is set off for a pregnancy, is it possibly meaningfully to clarify (medically to be able to treat in the self attempt), how it with the fertility with woman and man looks, in order possible problems before. If the woman and man physician give then green light, the immunosuppressive can be set off or replaced by cortisone.

But unfortunately pregnancies do not leave themselves always so perfectly plan.  If it should come during the treatment with immunosuppressive to an unplanned pregnancy, immediately the physician must be informed! Whether now the pregnancy be broken off it should or whether the immunosuppressive is set off, whether they are replaced by cortisone, whether one leaves everything with the past dosage or uses Immune globuline and or Plasma sphere becomes, depend surely on many factors. Nevertheless newer studies showed, which does not have Imurek with humans as can be prove damaging effect on the unborn. With women, who become more pregnant after a organ transplantation, even a continuation of the Imurek therapy is to be recommended (however surviving depends completely considerably on the Immunosuppression) with these women.

It is in any case advisable to look in such cases in the Internet for new research results! Antje arranged very good information about pregnancy and immunosuppressive drugs, and tips for further information search.

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Myasthenia Gravis Treatment Guidelines Part 1

The Myasthenia Gravis is now fairly well researched from a medical perspective. Only a few decades myasthenic are regularly died of their disease because lack of information about Myasthenia disease, myasthenia gravis today no shortening effect of longer life expectancy. There are a whole range of treatment options that attach to different points. Usually several ways to combine, in part, the methods are useful only in combination. Which medications should be taken in what dosage and what options are displayed when, can be set only individually. Experience of the physician is therefore essential for successful treatment of major importance.

The following information is collected from a layman’s medical and shaped by personal experience, they do not claim to scientific precision. Above all, they can not replace a visit to the myasthenia doctor!

Improvement of the attraction transmission

As the first and most important possibility of treatment the attraction transmission at the synapses is improved by medicines. Functions, as the dismantling of the chemical messenger acetyl choline is braked.  Several means stand to the selection, which work within short time, whose effect in addition, only short time continue.

Treatment of the immune system

With the treatment of the immune system can go a step further: the treatment of the immune system to slow down the formation of antibodies and stopping misguided at best, almost completely. For this are various medications and some treatments are available.

* Cortisone
Cortisone is a hormone that occurs naturally in the body is. For the treatment of many inflammatory diseases and to curb exuberant immune cortisone is produced artificially. In the treatment of myasthenia cortisone is used very successfully, strangely enough, it can happen in the first 2-3 weeks after starting treatment with temporary worsening of myasthenia.

* Immunosuppressants
Because in the long term steroid treatment may have relatively many side effects, other drugs are often used to slow the formation of antibodies. The effect of these medical treatment begins only very slowly, usually with an improvement after 3 to 4 months to be expected, but it may take up to two years until the success of treatment is evident. The treatment is therefore more long-term.

* Plasmapheresis and immuno adsorption
In myasthenia crisis and in severe cases, the antibodies can be mechanically removed from the blood. Plasmapheresis, part of the blood plasma is removed, as a substitute, there is human albumin or donor plasma. In immuno adsorption, the plasma is similar to a blood cleaning “. Both methods are relatively expensive and complex, so that improvement can be achieved fairly quickly, however. To prevent that, the body produces then – almost to compensate – particularly large number of antibodies that are usually used simultaneously cortisone and / or immunosuppressants. The effect of this treatment options may continue for several months to years.

* Immuno globulins
Conjugate is administered as an infusion. Like immuno adsorption plasmapheresis and IVIG are used in severe cases and in myasthenic crisis. The effect is roughly comparable, as in the two previously mentioned methods.

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