Thoulon J M, Galopin G, Seffert P, Garin J P, Dumont M
J Gynecol Obstet Biol Reprod (Paris). 1978 Dec;7(8):1395-403.
In the past 25 years, we have studied 73 cases of Myasthenia. 19 of these have had 24 pregnancies. We confirm the results that are given in the literature (15). Pregnancy does not trigger off Myasthenia. The action of pregnancy on Myasthenia is variable and there is an equal chance of worsening, improvement or a stationary state of the condition. All the same, patients who are well stabilised and have been for some time do not become worse. Worsening, when it does happen, happens especially in the first trimester of the pregnancy and calls for precise observation of the patient in order to regulate the treatment. Myasthenia has no direct or indirect action on the fetus and the pregnancy is not disturbed. Labour can be normal but the second stage often has to be aided because of the patient's muscle tiredness. In labour and particularly in the second stage an acute crisis can occur with difficulty in breathing. For this it is necessary to have an anaesthetist present who can resuscitate the patient and if necessary give respiratory aid by ventilation. Curare and like substances are absoultely contra-indicated if general anaesthesia is required. Transitory neonatal Myasthenia is rare, but the severity of the respiratory complications can be such that is should be sought for routinely and if there is the slightest doubt the newborn should be transferred to the special care neonatal unit.
在过去25年里，我们研究了73例重症肌无力患者。其中19例患者经历了24次妊娠。我们证实了文献（15）中给出的结果。妊娠不会引发重症肌无力。妊娠对重症肌无力的影响是可变的，病情加重、改善或维持稳定状态的几率相同。尽管如此，病情稳定一段时间的患者不会恶化。病情恶化尤其发生在妊娠的头三个月，因此需要对患者进行密切观察以便调整治疗。重症肌无力对胎儿没有直接或间接影响，妊娠也不会受到干扰。分娩过程可以正常，但由于患者肌肉疲劳，第二产程通常需要助产。分娩时，尤其是在第二产程，可能会发生急性危象并伴有呼吸困难。因此，必须有麻醉师在场，以便对患者进行复苏，并在必要时通过通气提供呼吸支持。如果需要全身麻醉，绝对禁用箭毒及类似药物。短暂性新生儿重症肌无力很少见，但呼吸并发症的严重程度可能很高，因此应常规进行检查，如有丝毫疑问，应将新生儿转入新生儿重症监护病房。
