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4 . 2024

Guillain–Barre syndrome during pregnancy and in the postpartum period

Abstract

The article presents an analysis of the literature on the etiology, pathogenesis, diagnosis and treatment of Guillain–Barre syndrome (GBS) in general, as well as during pregnancy and in the postpartum period. The risk factors for the development of the disease and the criteria for diagnosis are given. It is emphasized that the disease is rare, and research on the pathogenesis of GBS, as well as the development of new methods of treating the disease, is currently ongoing worldwide. It is noted that the disease is rare in pregnant women, and its frequency coincides with the general population. Literature data indicate that the triggers of GBS in pregnant women are both well-known factors (infections, vaccination, etc.) and the aggravated course of the gestational process (preeclampsia, diabetes mellitus, severe vomiting of pregnant women, COVID-19 during pregnancy). Surgical delivery and anesthesia may be the provoking factors for the development of GBS in the postpartum period. It is emphasized that the clinical picture of GBS in pregnant women is similar to that of non-pregnant women, and the diagnosis is based on descriptive clinical, laboratory (examination of cerebrospinal fluid) and electrodiagnostic criteria. Approaches to the treatment of GBS during pregnancy and in the postpartum period include intravenous administration of immunoglobulins, plasmapheresis, respiratory support, detection and treatment of infections, prevention of venous thromboembolism, anesthesia. A clinical case of Guillain–Barre syndrome in a pregnant woman with the development of bilateral polysegmental pneumonia, acute respiratory distress syndrome I grade and sepsis, which ended favorably for the mother and fetus due to an interdisciplinary approach in a multidisciplinary hospital, with a perinatal center in the composition. Recent studies indicate a more favorable course and outcomes of GBS in most pregnant women, which is most likely due to early detection of the disease, timely hospitalization and active use of plasmapheresis and intravenous immunoglobulins.

Conclusion. In case of untimely diagnosis and inadequate treatment of GBS during pregnancy, it can lead to severe and irreversible consequences for a woman’s life and health. Early diagnosis, a multidisciplinary approach and the use of modern methods of immunomodulatory therapy can provide a favorable outcome for both mother and fetus.

Keywords: Guillain–Barre syndrome; acute inflammatory demyelinating polyneuropathy; pregnancy; childbirth

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CHIEF EDITORS
CHIEF EDITOR
Sukhikh Gennadii Tikhonovich
Academician of the Russian Academy of Medical Sciences, V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation, Moscow
CHIEF EDITOR
Kurtser Mark Arkadievich
Academician of the Russian Academy of Sciences, MD, Professor, Head of the Obstetrics and Gynecology Subdepartment of the Pediatric Department, N.I. Pirogov Russian National Scientific Research Medical University, Ministry of Health of the Russian Federation
CHIEF EDITOR
Radzinsky Viktor Evseevich
Corresponding Member of the Russian Academy of Sciences, MD, Professor, Head of the Subdepartment of Obstetrics and Gynecology with a Course of Perinatology of the Medical Institute in the Russian People?s Friendship University named after P. Lumumbа
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