What is the role of plasma exchange (PLEX) and IV immune globulin (IVIg) in the treatment of pregnant patients with myasthenia gravis (MG)?

Updated: Aug 27, 2018
  • Author: Abbas Jowkar, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

PLEX or IVIg are useful when a prompt, although temporary, response is required during pregnancy.

Pregnant women with myasthenia gravis should be considered high-risk pregnancies and followed closely by an obstetrician, neonatologist, and a neuromuscular clinician. Planning for pregnancy should be instituted well in advance to allow time for optimization of myasthenic clinical status and to minimize risks to the fetus. Magnesium sulfate is avoided if possible if preeclampsia develops due to its neuromuscular blocking properties. It is preferable to give regional anesthesia for delivery and cesarean section.


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