Miljana Z. Jovandaric

By Miljana Z. Jovandaric and Svetlana J. Milenkovic

Myasthenia gravis (MG) is an autoimmune neuromuscular disease manifested by the weakness and fatigue in skeletal muscles of the face and extremities. Transient neonatal myasthenia gravis is an uncommon type of MG affecting the newborns with mothers who suffer from the disorder or specific circulating autoantibodies. In most cases, the intensity of transient neonatal MG is not associated with the mothers’ condition but rather with maternal antibody titers. The symptoms of transient neonatal MG are hypotonia, feeding difficulties, weak cry, facial diplegia, and breathing difficulties in the affected newborns. The disease is connected to the passive transplacental transfer of anti-acetylcholine receptor antibodies (anti-AChR) or antimuscle-specific tyrosine kinase antibodies (anti-MuSK) from the affected mother to the infant. The postsynaptic neuromuscular junction is damaged by the circulation of autoimmune antibodies, and the antibodies directed against fetal AChR are responsible for the form of fetal onset. Monitoring of these newborns is necessary in the first 7 days upon birth, since during this period of life, TNM symptoms can be detected, especially on the second day. In pregnancy period, myasthenia gravis symptoms may vary and they frequently worsen, sometimes leading to premature delivery.

Part of the book: Selected Topics in Myasthenia Gravis

By Miljana Z. Jovandaric and Svetlana J. Milenkovic

Placental abruption is a significant contributor to maternal mortality worldwide. Early and skilled medical intervention is needed to ensure a good outcome, and this is not available in many parts of the world. Abruptio placentae are defined as the premature separation of the placenta from the uterus. Placental abruption must be considered whenever bleeding is encountered in the second half of pregnancy, since it is a significant cause of third-trimester bleeding associated with fetal and maternal morbidity and mortality. If the bleeding persists, fetal and maternal distress may develop. Fetal and maternal death may occur if appropriate interventions are not undertaken. The severity of fetal distress correlates with the degree of placental separation. In near-complete or complete abruption, fetal death is inevitable unless an immediate cesarean delivery is undertaken.

Part of the book: Childbirth