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Monday, April 21, 2014
Myasthenia gravis and pregnancy
I was diagnosed with Myasthenia Gravis at 16, a month after I turned 17 I had a thymectomy. I have had no trouble with the disease since 2 months after surgery! I am now 21 and pregnant, I have been having problems with the disease again! My doctors do not know much about the disease, but that the pregnancy is causing it to come back! My mom is very worried because before the surgery I only had double vision and the tiredness, now I have almost all of the symptoms including inability to swallow and sometimes trouble breathing! My mom is very worried that having this baby could be very bad for me and she is urging me to terminate, I understand where she is coming from, but the doctors that I am seeing do not know very much about the disease and can not really determine the danger! I do not want the disease to come back at all, and I surely don’t want it to come back worse than it was before! Could you please give me a little advice as to what is in my best interest!
Regarding the MG: You need to work with a doctor who is familiar with MG. I would recommend that you look for a regional MDA (Muscular Dystrophy Association) clinic. The doctors that staff the clinic either have a lot of experience with MG or can connect you with someone who does. You can find a list of clinics on the web page (www.mdausa.org). Regarding your pregnancy and MG: 1) There are medications and treatments that can be used safely during pregnancy. Your neurologist should be experienced with handling MG in pregnant patients (see above). 2) Pregnancy appears to worsen some patients with MG, help some and have no effect on others. It is hard to predict. 3) You need to have a pediatrician (neonatologist) who will be able to handle any temporary problems with MG that the baby might have. In the final analysis, you should seek a more experienced neurologist (than you have now) to work with. This person can help by providing personalized information and care. Thanks for the question.
John G Quinlan, MD
Professor of Neurology
College of Medicine
University of Cincinnati