Hänsel Martin, Kalimeris Stylianos, Schreiner Bettina, Friedl Susanne, Cannizzaro Vincenzo, Keller Emanuela, Haslinger Christian, Brandi Giovanna
Institute for Intensive Care Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Department of Obstetrics, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
BMC Neurol. 2025 May 26;25(1):224. doi: 10.1186/s12883-025-04233-1.
Guillain-Barré syndrome (GBS) during pregnancy can be a very severe and life-threatening condition for both mother and child. GBS due to cytomegalovirus (CMV) in pregnancy is even rarer and may be associated with more respiratory insufficiency, cranial nerve involvement and sensory loss in the mother.
A 29-year-old secondparous woman at 25 weeks of gestation (WG) presented with a rapid ascending tetraparesis, bulbar paralysis, bilateral facial palsy, right-sided abducens paresis within 72 h of symptom onset and respiratory failure after 12 days. She needed intubation and mechanical ventilation for cumulative 42 days. GBS due to CMV primo-infection was diagnosed. A multidisciplinary team was involved to monitor and manage patient and fetus. In the electrodiagnostic studies, the patient presented severe primarily demyelinating features consistent with an acute inflammatory demyelinating (AIDP) GBS form treated with repeated plasma exchanges and administration of intravenous immunoglobulins. At 34 + 1 WG a cesarean delivery was performed, the newborn was healthy without intrauterine CMV-transmission.
The optimal time of delivery for intubated pregnant GBS patients is unknown. The mother's respiratory and medical conditions should be assessed in relation to premature-associated morbidity of the newborn.
妊娠期格林-巴利综合征（GBS）对母亲和孩子来说可能是一种非常严重且危及生命的疾病。妊娠期因巨细胞病毒（CMV）感染导致的GBS更为罕见，母亲可能出现更多呼吸功能不全、颅神经受累及感觉丧失的情况。
一名29岁经产妇，妊娠25周，在症状出现72小时内出现快速进展的四肢瘫、球麻痹、双侧面瘫、右侧展神经麻痹，12天后出现呼吸衰竭。她累计需要插管及机械通气42天。诊断为初次感染CMV所致的GBS。一个多学科团队参与对患者及胎儿的监测与管理。在电诊断研究中，患者表现出严重的以脱髓鞘为主的特征，符合急性炎症性脱髓鞘性（AIDP）GBS类型，接受了重复血浆置换及静脉注射免疫球蛋白治疗。妊娠34+1周时进行了剖宫产，新生儿健康，无宫内CMV传播。
插管的妊娠GBS患者的最佳分娩时间尚不清楚。应根据新生儿早产相关发病率评估母亲的呼吸及身体状况。
