A rare case of myasthenia gravis in pregnancy with impending eclampsia

Abstract

Managing myasthenia gravis during pregnancy is challenging due to its high-risk nature, particularly among women aged 20 to 30, coinciding with childbearing age. This risk is exacerbated when myasthenia gravis coexists with pregnancy-induced hypertension, leading to an increased threat of morbidity and mortality for both the mother and the fetus.This case report highlights the challenges associated with simultaneous occurrence of myasthenia gravis and pregnancy-induced hypertension, leading to impending eclampsia. Employing a multidisciplinary approach involving obstetricians, neurologists, anesthesiologists, and neonatologists was pivotal in addressing the complexities presented. An emergency cesarean section at the eighth month addressed worsening pre-eclampsia and respiratory distress. Strategic administration of a bolus of steroids and pyridostigmine, coupled with the use of cardiac-stable ropivacaine for spinal anesthesia, contributed to a successful procedure. Post-delivery, neonatal observation confirmed the absence of transient myasthenia gravis, with subsequent normal follow-up examinations for both mother and baby. This case underscores the need for a comprehensive approach in managing these uncommon but high-risk conditions during pregnancy.