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Verlauf und Behandlung der Myasthenia gravis in der Schwangerschaft

Course and treatment of myasthenia gravis during pregnancy

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Zusammenfassung

Familienplanung und Kinderwunsch sind häufig diskutierte Fragen in der Myastheniesprechstunde, da die Erstmanifestation häufig in die Lebensphase der Familienplanung fällt. Schwangerschaft, Geburt und Stillen bei Myastheniepatientinnen sind zwar mit einigen Besonderheiten verbunden, stellen in der Regel aber kein nennenswert erhöhtes Risiko im Vergleich zu normaler Schwangerschaft, Geburt und Wochenbett dar. Immer wiederkehrende Fragen betreffen sowohl den Verlauf der Schwangerschaft als auch den Einfluss der Myasthenie und insbesondere der medikamentösen Therapie auf die Schwangerschaft und das ungeborene Kind bzw. das Neugeborene. Einen besonderen Stellenwert nimmt hierbei die Frage der Entbindung ein, da es nach wie vor weit verbreitet ist, Myastheniepatientinnen primär per sectio zu entbinden.

Diese Übersicht soll als Grundlage für die individuelle Beratung und Betreuung von Myastheniepatientinnen dienen, die mit Kinderwunsch oder bereits eingetretener Schwangerschaft in die neurologische Sprechstunde kommen.

Summary

Pregnancy and family planning issues are frequent concerns in the medical care of patients with myasthenia gravis since disease onset often coincides with the life period which is decisive in this respect. Although pregnancy, delivery and breastfeeding represent special circumstances in these patients, they are not associated with higher risks of complications compared to normal pregnancy, delivery and postpartum period. Frequently asked questions regard the course of pregnancy as well as the impact of the disease and particularly medical treatment on pregnancy and the foetus or neonate. Great significance is attached to the mode of delivery since it is still widely accepted that patients with myasthenia gravis have to deliver per elective caesarean section. This paper gives an overview and provides a basis for the medical care and individual counselling of patients with myasthenia gravis who want to start a family or are already pregnant.

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Danksagung

Wir danken Sarah Hoffmann für die kritische Durchsicht der Arbeit. Die Autoren werden unterstützt von der Deutschen Forschungsgemeinschaft (EXC257), dem Bundesministerium für Forschung und Bildung (01 EO 08 01), der Helmholtz-Gemeinschaft (SO-022NG) und der Europäischen Union (FP7/2007–2013).

Interessenkonflikte

Der korrespondierende Autor weist auf folgende Beziehungen hin: Dr. J. Klehmet ist als Referentin für die Fa. Octopharm tätig. Prof. A. Meisel war als Referent der Fa. Temmler und Talecris tätig.

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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Authors and Affiliations

  1. Klinik für Neurologie, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland

    J. Klehmet

  2. Klinik für Neurologie, Myasthenie-Ambulanz, NeuroCure Clinical Research Center, Centrum für Schlaganfallforschung Berlin, Charité-Universitätsmedizin Berlin, Berlin, Deutschland

    A. Meisel

  3. Klinik für Geburtsmedizin, Charité Centrum für Frauen-, Kinder - und Jugendmedizin, Charité-Universitätsmedizin Berlin, Berlin, Deutschland

    J. Dudenhausen

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  1. J. Klehmet
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Correspondence to J. Klehmet.

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Klehmet, J., Dudenhausen, J. & Meisel, A. Verlauf und Behandlung der Myasthenia gravis in der Schwangerschaft. Nervenarzt 81, 956–962 (2010). https://doi.org/10.1007/s00115-010-2995-7

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