[The therapeutic strategy in transient neonatal myasthenia gravis]

The article deals with 17 pregnant women of whom 16 were treated for juvenile myasthenia gravis since childhood or adolescence, and one of them since she was 22 years old. Four of them (23%) gave birth to babies with transient neonatal myasthenia gravis: three of them had one ill child and one two diseased children. The significance of ultrasound follow-up of the strength of foetal movements of foetuses in risk for transient neonatal myasthenia gravis is stressed. Frequent controls of antibodies titers to acetylcholine receptors in myasthenic pregnant patients are very important whithout regard to their previous condition, whether they were thymectomized or not, and whether they used anticholinesterase medicaments or not during pregnancy. If high antibodies titar to acethylcholinesterase receptors is detected in the mother, especially in combination with slowed foetal movements, the therapy of choice is plasma exchange. Treatment principles of babies with transient neonatal myasthenia gravis are discussed; they are based on the data from literature, and our personal experience.