What should be noted by myasthenia gravis patients who are preparing for pregnancy?
I. Disease control
First, it is important to point out that patients with myasthenia gravis who have severe or progressive disease, especially female patients, should temporarily avoid pregnancy and childbirth to avoid deterioration of the disease.
Secondly, male and female patients with myasthenia gravis of childbearing age should fully communicate with the attending neurologist before planning pregnancy or preparing for pregnancy in order to adjust the treatment and then make a family plan accordingly.
Again, after standardized treatment, most patients with myasthenia gravis will gradually stabilize or be in long-term remission, and many patients can gradually discontinue immunosuppressive drugs (including azathioprine and tacrolimus), while some patients still require low-dose glucocorticoids (prednisone) for maintenance therapy.
In addition, if the patient has a thymoma then thymectomy should be performed as early as possible. Male patients can conceive their wives by following the above principles of medication use and following medical advice, and by maintaining a positive and optimistic attitude.
For women of childbearing age, it is best for female patients to conceive when they are in remission and have been off immunosuppressive drugs for at least 3 months. As long as the disease is in mild remission (MM) and immunosuppressive drugs (except prednisone) can be stopped after treatment, a baby can be considered. The general recommendation for conception is after 2-3 years of disease and systemic treatment.
The reasons are.
- previous studies have shown that the risk of myasthenia gravis crisis in pregnant women with myasthenia gravis is inversely proportional to the duration of their disease. That is, the patient has the highest risk of developing a crisis within the first year after the onset of the disease, and the risk decreases the longer the disease duration. This is also related to the natural history of myasthenia gravis, where most patients with myasthenia gravis reach their highest disease severity within 2-3 years after the onset of the disease. Therefore, the risk of exacerbation of the disease is greatly reduced when pregnancy occurs after 2-3 years of illness.
2, combined with the treatment cycle of myasthenia gravis, relatively speaking, after 2-3 years of standard treatment, most patients’ disease will be controlled and in a stable state.
3、After 2-3 years of illness, patients have a better understanding of the fluctuation of their disease changes and
At this time, both doctors and patients can decide more clearly whether it is suitable for pregnancy according to their conditions.
- Routine pre-pregnancy examination
In addition to the examination and treatment of myasthenia gravis, it is more necessary for female patients with myasthenia gravis to undergo pre-pregnancy check-ups than ordinary women.
(1) The examination for female patients usually includes
(1) Pre-pregnancy tests for female patients usually include routine blood and urine tests, liver and kidney function, thyroid function, gynecological ultrasound, electrocardiogram, chest X-ray, gynecological endocrinology and complete physical examination, etc.
(2) Tests for male patients: routine urinary system and blood
Semen examination is also recommended, including semen volume, color, viscosity, liquefaction, ph value, sperm density, motility, morphology and other items.
Other routine conditioning
- Physical conditioning. We should strive to adjust our physical condition to the best, and treat other diseases in a timely manner.
2、Ensure sleep and rest. Adequate sleep is an important condition for the body to maintain a good state.
3, nutritional state conditioning. To pay attention to food diversification, strengthen nutrition, more protein-rich food, appropriate more vegetables and fruits, drink more plain water, as far as possible, do not drink coffee and tea and other stimulating drinks, do not smoke, do not drink.
4, relaxed mood. Arrange your work well, finish your work during office hours as much as possible, and avoid working overtime and staying up late. In daily life, more reading to cultivate the body and mind; timely elimination of negative emotions; more communication and more love between husband and wife, so that family harmony, physical and mental happiness.
5, appropriate exercise. Appropriate exercise is beneficial to both male and female patients to increase the chances of conception, in daily life, patients should choose the appropriate exercise methods to strengthen their bodies. At the same time, we should pay attention to avoid fatigue from excessive exercise, otherwise the effect of conditioning is counterproductive.
