STUDIJA DVOSMERNE POVEZANOSTI MIASTENIJE GRAVIS I TRUDNOĆE

  • Gordana Djordjevic Medicinski Fakultet Niš
  • Aleksandar Stojanov Neurolog, UKC Niš
Ključne reči: miastenija gravis, trudnoća, klinički tok

Sažetak


 

Usled velike prevalencije miastenije gravis (MG) kod žena u reproduktivnom periodu, pojava trudnoće kod ovih bolesnica nije neuobičajena. Ovo zahteva poseban klinički i terapijski oprez. Postoji dvosmerni odnos MG i trudnoće: trudnoća može uticati na klinički tok MG, a takođe sama bolest može uticati na porođaj i pojavu postnatalnih komplikacija. Cilj naše studije bio je da se proceni uticaj MG na klinički tok, porođaj i ishod neonatusa kod trudnica. Klinička slika tokom trudnoće, porođaja i u postpartalnom periodu praćena je kod 23 novorođenčeta, rođenih od strane 15 majki sa dijagnozom MG. Spontani abortus primećen je u dva slučaja (8%), u drugom mesecu trudnoće. Kod jednog novorođenčeta dijagnostikovana je tranzitorna neonatalna MG. Nije bilo mrtvorođenih i nije bilo fizičkih anomalija kod novorođenčadi. Kliničko pogoršanje utvrđeno je tokom 10 trudnoća (40%) kod 8 trudnica. Klinički tok MG tokom trudnoće je varijabilan i nepredvidljiv, ali trudnoća ne utiče na dugotrajni ishod MG. Spontani abortus je potencijalna komplikacija kod žena sa MG. Carski rez je intervencija koja se češće sprovodi kod žena sa MG u odnosu na opštu populaciju. Timektomija kod žena sa MG, pre porođaja, može imati pozitivni efekat na novorođenčad. Neonatalna tranzitona MG bila je retka u našoj populaciji. Nije bilo kongenitalnih anomalija kod 23 novorođenčeta u našoj ustanovi.

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