Lake Adam J, Al Khabbaz Antoun, Keeney Renée
Department of Obstetrics and Gynecology, University of Illinois College of Medicine at Rockford, 1601 Parkview Ave., Rockford, IL 61101, USA.
Department of Women, Children, and Family Health, University of Illinois College of Nursing at Rockford, 1601 Parkview Ave., Rockford, IL 61101, USA.
Case Rep Obstet Gynecol. 2017;2017:9204930. doi: 10.1155/2017/9204930. Epub 2017 Feb 9.
Myasthenia gravis (MG) is a rare autoimmune disease that leads to progressive muscle weakness and is common during female reproductive years. The myasthenic mother and her newborn must be observed carefully, as complications during all stages of pregnancy and the puerperium may arise suddenly. Preeclampsia is a common obstetrical condition for which magnesium sulfate is used for seizure prophylaxis. However, magnesium sulfate is strongly contraindicated in MG as it impairs already slowed nerve-muscle connections. Similarly, many first-line antihypertensive medications, including calcium channels blockers and -blockers, may lead to MG exacerbation. This case describes the effective obstetrical management of a patient with MG who developed severe preeclampsia. The effective use of levetiracetam and various antihypertensive medications including intravenous labetalol is described. A review of the ten reported cases of MG complicated by preeclampsia is examined to aggregate observations of clinical care, with focus on delivery methods, anticonvulsants, and antihypertensive medications.
重症肌无力（MG）是一种罕见的自身免疫性疾病，可导致进行性肌肉无力，在女性生育年龄较为常见。重症肌无力母亲及其新生儿必须得到密切观察，因为在妊娠和产褥期的各个阶段都可能突然出现并发症。子痫前期是一种常见的产科疾病，硫酸镁用于预防惊厥。然而，硫酸镁在重症肌无力中是强烈禁忌的，因为它会损害已经减慢的神经肌肉连接。同样，许多一线抗高血压药物，包括钙通道阻滞剂和β受体阻滞剂，可能会导致重症肌无力加重。本病例描述了一名患有重症肌无力并发展为重度子痫前期患者的有效产科管理。文中描述了左乙拉西坦和包括静脉注射拉贝洛尔在内的各种抗高血压药物的有效使用。本文回顾了十例报告的重症肌无力合并子痫前期的病例，以汇总临床护理观察结果，重点关注分娩方式、抗惊厥药物和抗高血压药物。
