English abstract
Myasthaenia gravis (MG) is an autoimmune neuromuscular disorder which is twice as common
among women, often presenting in the second and third decades of life. Typically, the first trimester of pregnancy
and first month postpartum are considered high-risk periods for MG exacerbations. During pregnancy, treatment
for MG is usually individualised, thus improving its management. Plasma exchange and immunoglobulin therapies
can be safely used to treat severe manifestations of the disease or myasthaenic crises. However, thymectomies are
not recommended because of the delayed beneficial effects and possible risks associated with the surgery. Assisted
vaginal delivery—either vacuum-assisted or with forceps—may be required during labour, although a Caesarean
section under epidural anaesthesia should be reserved only for standard obstetric indications. Myasthaenic women
should not be discouraged from attempting to conceive, provided that they seek comprehensive counselling and
ensure that the disease is under good control before the start of the pregnancy.
