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Eur J Cardiothorac Surg 2006;29:231-235
© 2006 Elsevier Science NL

Effect of pregnancy and birth on the course of myasthenia gravis before or after transsternal radical thymectomy

^a Division of General Thoracic Surgery, University Hospital, 3010 Berne, Switzerland
^b Division of Neurology, University Hospital, Berne, Switzerland

Received 29 August 2005; received in revised form 16 November 2005; accepted 21 November 2005.

^_* Corresponding author. Tel.: +41 31 632 23 30; fax: +41 31 632 23 27. (Email: ralph.schmid{at}insel.ch).

Objective: Myasthenia gravis (MG) affects women at childbearing age. Therefore, the question arises if these patients should become pregnant and if thymectomy has a positive effect on the course of MG in pregnant patients. Methods: Fifteen pregnancies had been followed retrospectively. All patients underwent transsternal radical thymectomy for MG. The course of MG in the period before, during, and after the pregnancy was scored according to Ossermann's classification. The effect of thymectomy on delivery and on the newborns was evaluated. Results: Patients were divided in two groups: pregnancies before (group I, n = 8) and after (group II, n = 7) thymectomy. During pregnancy, in group I, one deterioration was observed and in seven patients the disease was unchanged. In group II, one deterioration, five unchanged courses, and one improvement were observed. In the postpartum period, in group I, seven patients did not change and one improved. In group II, two deteriorations, three unchanged courses, and two improvements were observed. Before pregnancy, group II patients were in a better Ossermann stage in comparison with those in group I. Eight of the 12 deliveries were spontaneous (three abortus). Myasthenic symptoms were observed in two newborns in group I. Conclusion: Our data suggest that MG is not prohibitive to have children. The course of MG after transsternal radical thymectomy is often ameliorated. A better MG-stage, reached after thymectomy, before pregnancy seems to be correlated with a better course during pregnancy.

Key Words: Myasthenia gravis • Thymectomy • Pregnancy • Delivery • Newborn

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				J. F. T. Zenteno Can we consider thymectomy before pregnancy in female patients with myasthenia gravis? Eur. J. Cardiothorac. Surg., August 1, 2006; 30(2): 411 - 412. [Full Text] [PDF]