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Friday, August 1, 2014
Pregnancy & MG
I am currently being treated with prednesilone and mestinon for Ocular Myasthenia Gravis. I am very worried about the side effects of this on an unborn child. What are my chances of having a normal, healthy baby???
Medication use during pregnancy is always a matter of weighing risk vs. benefit -- something that can not be done by internet. You should talk this over with your treating neurologist. It is often important to discuss the timing of stopping medications with your treating neurologist. Sometimes we have patients stop their medications as a trial to see how they will do. It also allows you to be off medications (if that is the safest plan) when you conceive.
Mestinon is rated category B (no evidence for risk but good evidence assuring safety is lacking) and prednisolone is C (risk uncertain).
If you do plan to have a baby, you should make sure that the OB is aware of your MG. There is a temporary form of MG that can affect the baby at birth and for days afterward. Also MG could become generalized during the pregnancy and this would affect methods of delivery and other management decisions.
The key is to work with your neurologist and OB. The odds are quite good that you will have an uneventful pregnancy and a normal healthy baby. It is just important to be prepared if things do not go smoothly.
Best of luck.
John G Quinlan, MD
Professor of Neurology
College of Medicine
University of Cincinnati