{
  "abstract": "Effective management of Myasthenia Gravis (MG) during pregnancy is essential for optimal maternal and neonatal outcomes. We evaluated outcomes in women with MG onset before age 50 and a history of pregnancy, using data from the West of Scotland Myasthenia database and UK 2011 best-practice guidelines.Sixteen patients with 29 pregnancies were included, with two pregnancies resulting in first-trimester fetal demise. The mean age at MG onset was 22.3 years, and at pregnancy 29.9 years. Generalised MG was predominant (69%) and 75% of patients were AChR antibody positive. Thymectomy was performed in 69%. During pregnancy, 34% were on no medication, while the rest were on combinatory treatment of pyridostigmine with prednisolone and/or a steroid-sparing immunosuppressant (azathioprine or cyclosporine).Relapses occurred in 28% pre-pregnancy and 34% during pregnancy, largely managed as outpatients with treatment adjustments. Pre-pregnancy counselling was documented in 41% and neurology was notified in 86%. Multidisciplinary care was documented in 59% of pregnancies.Most deliveries were vaginal (37%) at a mean gestational age of 38.9 weeks. No maternal MG deterioration occurred at time of delivery and neonatal outcomes were favorable, with no cases of transient neonatal MG. Postpartum exacerbations occurred in 30% requiring treatment escalation.valentina.fenech2@nhs.scot",
  "authors": [
    {
      "affiliations": [
        "Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, UK"
      ],
      "name": "Fenech Valentina"
    },
    {
      "affiliations": [
        "Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, UK"
      ],
      "name": "Carmichael Caroline"
    },
    {
      "affiliations": [
        "Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, UK"
      ],
      "name": "Farrugia Maria Elena"
    }
  ],
  "title": "81 Evaluating maternal and neonatal outcomes in myasthenia gravis patients in the West of Scotland",
  "uid": "2171d504-003e-52f5-9168-f48f696092e0"
}