Generalized Myasthenia Gravis in Pregnancy: Case Report

Abstract

Myasthenia gravis (MG) is an autoimmune disorder caused by autoantibodies that bind to the postsynaptic membrane at the neuromuscular junction (NMJ) characterized by weakness and fatigue of the skeletal muscles. During pregnancy, MG can occur at any time, either in the first to the third trimester. However, MG is usually new or worsens in only about one-third of pregnant patients. Mrs. F, 33 years old, 24 weeks pregnant, came with complaints of difficulty swallowing since a week before entering the hospital and has been getting worse since today afternoon. The patient admits that it is difficult to swallow food or drink and often chokes. The patient also admits that it is difficult to speak, the voice uttered by the patient sounds nasal. Both patient’s eyelids droop, but not all the time. These complaints get worse when the patient has a lot of activity. On neurological examination, abnormalities in the cranial nerves were found, namely ptosis (+/+), dysarthria, and dysphagia. Examination of the patient's motor within normal limits, there is no weakness in the patient's limbs. On obstetric examination found within normal limits. On routine blood laboratory examination found anemia. The patient was then given pyridostigmine 3 x 60 mg, ranitidine IV 50 mg/12 hours, and methylprednisolone 62.5 mg/12 hours. During treatment the patient's general condition improved and the patient's complaints decreased so that the patient was then sent home and rescheduled for control to the neurologist's polyclinic. Myasthenia gravis in pregnancy is very important to know and get the right treatment because it can have an impact on the mother and fetus.