Hassan Ali, Yasawy Zakia M
Department of Neurology, King Fahd Hospital, University of Dammam, Khobar, Saudi Arabia.
Sultan Qaboos Univ Med J. 2017 Aug;17(3):e259-e267. doi: 10.18295/squmj.2017.17.03.002. Epub 2017 Oct 10.
(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.
重症肌无力（MG）是一种自身免疫性神经肌肉疾病，在女性中更为常见，发病率是男性的两倍，通常在人生的第二个和第三个十年发病。一般来说，妊娠的头三个月和产后第一个月被认为是重症肌无力病情加重的高危期。在怀孕期间，重症肌无力的治疗通常是个体化的，从而改善其管理。血浆置换和免疫球蛋白疗法可安全用于治疗该疾病的严重表现或肌无力危象。然而，由于手术的有益效果延迟且存在相关风险，不建议进行胸腺切除术。分娩期间可能需要辅助阴道分娩——无论是真空辅助还是使用产钳——不过硬膜外麻醉下的剖宫产仅应保留用于标准产科指征。重症肌无力女性不应因尝试怀孕而气馁，前提是她们寻求全面的咨询并确保在怀孕开始前病情得到良好控制。
