Successful maternal and fetal outcome of Guillain-Barre syndrome complicating pregnancy: a case report
Keywords:
Guillain-Barré syndrome, Plasmapheresis, ImmunoglobulinsAbstract
Guillain-Barré syndrome rarely complicates pregnancy, incidence being 2/100000 population. We report a case of 23-year-old 2nd gravida who developed a progressive ascending paralysis during the second trimester of pregnancy. The worsening of the respiratory insufficiency required transfer to an intensive care unit but did not require artificial ventilation. Cerebrospinal fluid examination revealed albumin-cytological dissociation and repeated electrophysiological studies showed typical features of demyelinating neuropathy with conduction blocks. Biological investigations, especially CMV and campylobacter jejuni serologies, were all negative. Intravenous immunoglobulin infusions resulted in rapid improvement in the patient. This case raises the question of the relationship between the Guillain-Barré syndrome and pregnancy. The occurrence of the disease, as well as the rapid recovery in antenatal period could be consecutive to a partial failure of the maternal immunological tolerance toward the fetus.Metrics
References
Yip SK, Hin LY, Chung TKH. Effect of the duration of labor on postpartum postvoid residual bladder volume. Gynecol Obstet Invest 1998;45:177-80.
Ching-Chung L, Shuenn-Dhy C, Ling-Hong T, Ching-Chang H, Chao-Lun C, Po-Jen C. Postpartum urinary retention: assessment of contributing factors and long-term clinical impact. Aust N Z J Obstet Gynaecol. 2002 Oct;42(4):365-8.
Groutz A, Gordon D, Wolman I, Jaffa A, Kupferminc MJ, Lessing JB. Persistent postpartum urinary retention in contemporary obstetric practice. Definition, prevalence and clinical implications. J Reprod Med 2001;46:44-8.
Cardozo L, Gleeson C. Pregnancy, childbirth and continence. British Journal of Midwifery 1997;5:277-81.
Rizvi RM, Khan ZS, Khan Z. Diagnosis and management of postpartum urinary retention. Int J Gynecol Obstet 2005;91:71-2.
Carley ME, Carley JM, Vasdev G, Lesnick TG, Webb MJ, Ramin KD, et al. Factors that are associated with clinically overt postpartum urinary retention after vaginal delivery. Am J Obstet Gynecol 2002;187: 430-3.
Vakalopoulos I, Kampantais S, Dimopoulos P, Papastavros C. Treatment of obstructive uropathy in one of three young brothers suffering from Gorlin-Cohen syndrome: a case report. BMC Urol 2012;12:2.