Anaesthesia in a Parturient with Myasthenia Gravis- Transient Myasthenia in newborn

Myasthenia gravis is an acquired chronic autoimmune disorder caused by decrease in functioning of acetylcholine receptors at the neuromuscular junctions owing to their destruction or inactivation by circulating antibodies. Disease manifests in the form of easy fatigability, weakness, difficulty in swallowing and even paralysis of respiratory muscles necessitating assisted ventilation. The clinical course of myasthenia gravis and its effect on pregnancy outcome is unpredictable. Worsening of symptoms can occur at any stage during pregnancy and also in post operative period. We are reporting a case of maternal myasthenia gravis who underwent caesarean section and developed respiratory distress after 20 minutes of spinal anaesthesia. Her baby also had a weak cry, hypotonia and tachypnoea. Baby was shifted to neonatal intensive care unit with continuous oxygen supplementation. Baby was kept under close observation and recovered well after two weeks.