Successful outcome of pregnancy in a case of Guillain Barre syndrome-report of a rare case and review of literature
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20223143Keywords:
GBS, Neurological disorder, Ascending paralysisAbstract
Guillain Barre syndrome (GBS) is a rare autoimmune neurological disorder that has been reported to carry a high maternal risk and maternal mortality risk of >10% if occurred during pregnancy. It is characterized by acute onset of symmetrical ascending paralysis with or without respiratory depression and autonomic dysfunction secondary to gastrointestinal or respiratory infection. This is case report of 30 years old multigravida who presented at 19 weeks period of gestation with sudden onset back pain and bilateral lower limb weakness that progressed to involve bilateral upper limbs with respiratory insufficiency. Based on clinical presentation and relevant investigations like serum electrolyte, arterial blood gas analysis and nerve conduction studies, provisional diagnosis of GBS was made. In collaboration with the physician, she was managed with ventilator support for 12 days, intravenous immunoglobulin and supportive therapy. This was followed by complete and rapid recovery as she was extubated on 12th day and discharged on day 16. Patient was followed by strict maternal and fetal surveillance. She successfully delivered a healthy boy at 38 weeks of period of gestation by caesarean section done in view of meconium-stained liquor grade 3 in early labour and she was discharged on day 3 of LSCS.
References
Zafar MS, Naqash MM, Bhat TA, Malik GM. Guillain-barré syndrome in pregnancy: an unusual case. J Family Med Prim Care. 2013;2(1):90-1.
Silva F, Paula G, Automari CV, Almeida DS, Guimarães R. Guillain-barré syndrome in pregnancy: early diagnosis and treatment is essential for a favorable outcome. Gynecol Obstet Invest. 2009;67(4):236-7.
Hadden RD, Gregson NA. Guillain--Barré syndrome and Campylobacter jejuni infection. Symp Ser Soc Appl Microbiol. 2001;(30):145-54.
Willison HJ, Jacobs BC, Doorn PA. Guillain-Barré syndrome. Lancet. 2016;388(10045):717-27.
Pacheco LD, Saad AF, Hankins GD, Chiosi G, Saade G. Guillain-Barré Syndrome in Pregnancy. Obstet Gynecol. 2016;128(5):1105-10.
Elovaara I, Apostolski S, Doorn P, Gilhus NE, Hietaharju A, Honkaniemi J, et al. EFNS guidelines for the use of intravenous immunoglobulin in treatment of neurological diseases: EFNS task force on the use of intravenous immunoglobulin in treatment of neurological diseases. Eur J Neurol. 2008;15(9):893-908.
Chan LY, Tsui MH, Leung TN. Guillain-Barré syndrome in pregnancy. Acta Obstet Gynecol Scand. 2004;83(4):319-25.
Wiertlewski S, Magot A, Drapier S, Malinovsky JM, Péréon Y. Worsening of neurologic symptoms after epidural anesthesia for labor in a Guillain-Barré patient. Anesth Analg. 2004;98(3):825-7.