1.Pregnancy-related Guillain-Barré syndrome: A Case Series
Diah Kurnia Mirawati ; Subandi Subandi ; Baarid Luqman Hamidi ; Dody Wahyu Lestya Nugraha ; Aiman Hilmi Asaduddin ; Maulana Firdaus Syahrizal ; Stefanus Erdana Putra ; Muhammad Hafizhan
Malaysian Journal of Medicine and Health Sciences 2024;20(No.1):383-388
Introduction: Pregnancy-related Guillain-Barré syndrome (GBS) is a rare autoimmune disorder that affects pregnant
women. With an annual incidence ranging from 0.81 to 1.89 cases per 100,000 population, GBS can occur at any
trimester of pregnancy, as well as during the postpartum period are susceptible to GBS. The pillars of managing
pregnancy-related GBS to improve outcomes include early diagnosis, prompt immune-modulatory therapy, and multidisciplinary input. Case Series: In this study, three case of GBS in pregnancy were reported. The first patient was a
35-year-old woman, G3A1P2 post emergency Transperitoneal Cesarean Section (TPCS), who experienced with lower limb weakness three days before TPCS. After being diagnosed with severe eclampsia and underwent emergency
TPCS, her complaint of lower limb weakness worsened. The second patient, a 27-year-old woman, with G2P1A0
experienced weakness in all four limbs. The third patient, a 20-year-old woman with G1P0A0, in the third semester
presented with weakness in all four limbs. The electroneurography investigation conducted on these patients supported the diagnosis of GBS, which was subsequently managed with plasma exchange (PE). After the administration
of PE, there was observed improvement in the clinical manifestation of GBS. Conclusion: The development of GBS
in pregnancy is typically preceded by bacterial or viral infection. Preeclampsia was found to be associated with two
folds risk of GBS, which was usually diagnosed based on the neurological examinations with supportive studies, including serological tests, cerebrospinal fluid analysis and electroneurography. The management of pregnancy-related
GBS included intravenous immunoglobulin, PE, physiotherapy, and supportive therapy, such as ventilator support.


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