Association of preeclampsia and myasthenia: a case report.

BACKGROUND

Myasthenia gravis in pregnancy is uncommon, and its occurrence in conjunction with preeclampsia is very rare but may be catastrophic for mother and child.

CASE

A 31-year-old, multiparous woman, with a history of myasthenia gravis and thymectomy, presented at 27 weeks with worsening preeclampsia and delivered by cesarean section under spinal anesthesia. Preeclamptic crisis with hemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome developed postpartum. Blood pressures remained severely high. Intensive care management and a labetalol drip resolved the crisis.

CONCLUSION

Added complications may arise from myasthenic exacerbation, difficulties in early recognition of signs and symptoms, and the use of medications that slow neuromuscular transmission.