Pregnancy: neuromuscular complications

Jackie Whitesell MD (Dr. Whitesell of Saint Alphonsus Regional Medical Center and the University of Washington has no relevant financial relationships to disclose.)
Zachary N London MD (Dr. London of the University of Michigan has no relevant financial relationships to disclose.)
Matthew Lorincz MD PhD, editor. (Dr. Lorincz of the University of Michigan receives salary support from Wilson Therapeutics AB for performing UWDRS examinations in a clinical trial.)
Originally released June 11, 2004; last updated August 25, 2015; expires August 25, 2018

Overview

Neuromuscular conditions that affect women during pregnancy are diverse. The author examines a broad range of neuromuscular disorders that may complicate pregnancy. The discussion is divided into 2 parts. The first half of the discussion is on disorders that initially present during pregnancy, including Bell palsy, carpal tunnel syndrome, radiculopathy, and lower extremity mononeuropathies. These disorders are felt to be self-limiting; however, data suggest a high rate of residual neuropathies following pregnancy. The second half of the dialogue addresses the ramifications of pregnancy and delivery on preexisting neuromuscular disorders, such as myasthenia gravis and muscular dystrophies.

Key points

 

• Treatment of Bell palsy during pregnancy is controversial, but the majority of pregnant patients have an excellent recovery with or without treatment.

 

• Mononeuropathies and radiculopathies occurring during pregnancy should be treated conservatively because most resolve weeks to months after delivery.

 

• Pregnant women with hereditary neuropathies and muscular dystrophies can have a decline in muscle strength during pregnancy. They are also at risk for maternal and fetal complications during delivery.

 

• Pregnant women with myasthenia gravis should be monitored for clinical worsening during delivery and the postpartum period.

 

• Newborn infants of mothers with myasthenia gravis need close observation in the first few days after birth for transient neonatal myasthenia gravis.

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