{"id":643,"date":"2022-10-25T22:55:50","date_gmt":"2022-10-25T22:55:50","guid":{"rendered":"https:\/\/centrodemiastenia.com\/medicos\/?page_id=643"},"modified":"2022-11-16T19:47:58","modified_gmt":"2022-11-16T19:47:58","slug":"miastenia-y-embarazo","status":"publish","type":"page","link":"https:\/\/centrodemiastenia.com\/medicos\/miastenia-y-embarazo\/","title":{"rendered":"Miastenia y embarazo"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"643\" class=\"elementor elementor-643\">\n\t\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1b85ea7 elementor-section-height-min-height elementor-section-items-stretch elementor-section-boxed elementor-section-height-default\" data-id=\"1b85ea7\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-36441ca0\" data-id=\"36441ca0\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-348588c elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"348588c\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-7da64c4\" data-id=\"7da64c4\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-cd4cf50 elementor-widget elementor-widget-heading\" data-id=\"cd4cf50\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.8.1 - 13-11-2022 *\/\n.elementor-heading-title{padding:0;margin:0;line-height:1}.elementor-widget-heading .elementor-heading-title[class*=elementor-size-]>a{color:inherit;font-size:inherit;line-height:inherit}.elementor-widget-heading .elementor-heading-title.elementor-size-small{font-size:15px}.elementor-widget-heading .elementor-heading-title.elementor-size-medium{font-size:19px}.elementor-widget-heading .elementor-heading-title.elementor-size-large{font-size:29px}.elementor-widget-heading .elementor-heading-title.elementor-size-xl{font-size:39px}.elementor-widget-heading .elementor-heading-title.elementor-size-xxl{font-size:59px}<\/style><h2 class=\"elementor-heading-title elementor-size-default\">Miastenia y embarazo<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-688d5d0 elementor-widget elementor-widget-spacer\" data-id=\"688d5d0\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.8.1 - 13-11-2022 *\/\n.elementor-column .elementor-spacer-inner{height:var(--spacer-size)}.e-con{--container-widget-width:100%}.e-con-inner>.elementor-widget-spacer,.e-con>.elementor-widget-spacer{width:var(--container-widget-width,var(--spacer-size));-ms-flex-item-align:stretch;align-self:stretch;-ms-flex-negative:0;flex-shrink:0}.e-con-inner>.elementor-widget-spacer>.elementor-widget-container,.e-con-inner>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer,.e-con>.elementor-widget-spacer>.elementor-widget-container,.e-con>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer{height:100%}.e-con-inner>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer>.elementor-spacer-inner,.e-con>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer>.elementor-spacer-inner{height:var(--container-widget-height,var(--spacer-size))}<\/style>\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-7525e91 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"7525e91\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;gradient&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-30da6b7\" data-id=\"30da6b7\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-40709068 elementor-widget__width-initial elementor-widget-tablet__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"40709068\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.8.1 - 13-11-2022 *\/\n.elementor-widget-text-editor.elementor-drop-cap-view-stacked .elementor-drop-cap{background-color:#818a91;color:#fff}.elementor-widget-text-editor.elementor-drop-cap-view-framed .elementor-drop-cap{color:#818a91;border:3px solid;background-color:transparent}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap{margin-top:8px}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap-letter{width:1em;height:1em}.elementor-widget-text-editor .elementor-drop-cap{float:left;text-align:center;line-height:1;font-size:50px}.elementor-widget-text-editor .elementor-drop-cap-letter{display:inline-block}<\/style>\t\t\t\tDesde el punto de vista de la salud materno-fetal, la miastenia gravis es compatible con el embarazo y no hay motivo para desalentar la concepci\u00f3n. Sin embargo, se considera que el embarazo es de alto riesgo en las mujeres con miastenia debido a que puede tener resultados adversos, y es necesario el seguimiento por un equipo multidisciplinario.<sup>1<\/sup>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-7c473b4 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"7c473b4\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-46c7d65\" data-id=\"46c7d65\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-416d268 elementor-widget elementor-widget-text-editor\" data-id=\"416d268\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>Los anticuerpos anti receptores de acetilcolina nicot\u00ednicos (ACRA) pueden ingresar a la circulaci\u00f3n sangu\u00ednea fetal y afectar la uni\u00f3n neuromuscular, causando:<sup>1,2<\/sup><br \/>\u2022 Miastenia neonatal transitoria (10-20%), auto limitada o,<br \/>\u2022 Artrogriposis m\u00faltiple cong\u00e9nita (1% de las gestaciones).<br \/>El asesoramiento prenatal es importante. Las mujeres que planifiquen o deseen quedar embarazadas deben suspender ciertos f\u00e1rmacos (metotrexato, micofenolato mofetil, rituximab) con suficiente antelaci\u00f3n, antes de la concepci\u00f3n.<sup>1,2<\/sup><br \/>Se recomienda la inmunizaci\u00f3n de todas las mujeres miast\u00e9nicas antes del embarazo, incluidas las vacunas contra la influenza y el COVID-19. Las vacunas con virus vivos atenuados est\u00e1n contraindicadas en quienes reciben terapia inmunosupresora.<sup>1<\/sup><br \/>Los riesgos para la gestante y el feto son m\u00ednimos si la miastenia es leve y se ha mantenido bajo control. La mayor\u00eda de las pacientes se mantienen estables durante el embarazo. Se deben evitar los factores desencadenantes: f\u00e1rmacos, infecciones, etc.<sup>1<\/sup><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-14c21e6\" data-id=\"14c21e6\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5a53afa6 elementor-widget elementor-widget-image\" data-id=\"5a53afa6\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.8.1 - 13-11-2022 *\/\n.elementor-widget-image{text-align:center}.elementor-widget-image a{display:inline-block}.elementor-widget-image a img[src$=\".svg\"]{width:48px}.elementor-widget-image img{vertical-align:middle;display:inline-block}<\/style>\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"441\" height=\"540\" src=\"https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Ilus_Embarazada.svg\" class=\"attachment-full size-full\" alt=\"\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-43797fec elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"43797fec\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-7a96613c\" data-id=\"7a96613c\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-4238bb9 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"4238bb9\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-7156e440\" data-id=\"7156e440\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-b0b58bb elementor-widget elementor-widget-heading\" data-id=\"b0b58bb\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">DURANTE LA GESTACI\u00d3N<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ad93536 elementor-widget elementor-widget-text-editor\" data-id=\"ad93536\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>Se aconseja administrar \u00e1cido f\u00f3lico desde que se planifica la concepci\u00f3n hasta el segundo trimestre de gestaci\u00f3n.<sup>1<\/sup><\/p><p>Utilizar la medicaci\u00f3n que se considera segura: anticolinester\u00e1sicos en primera l\u00ednea y, si fuera necesario, corticoesteroides, azatioprina, ciclosporina; inmunoglobulina intravenosa o plasmaf\u00e9resis son opciones temporarias.<sup>1,2<\/sup><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-296d181 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"296d181\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-edf4bc8\" data-id=\"edf4bc8\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-d3c8571 elementor-widget elementor-widget-heading\" data-id=\"d3c8571\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">CONTROLES ECOGR\u00c1FICOS SUGERIDOS<sup>1<\/sup>\n<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-d3e45e2 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"d3e45e2\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-9632f35\" data-id=\"9632f35\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-e8211de elementor-widget elementor-widget-image\" data-id=\"e8211de\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"378\" height=\"373\" src=\"https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Ilus_Control.png\" class=\"attachment-full size-full\" alt=\"\" loading=\"lazy\" srcset=\"https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Ilus_Control.png 378w, https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Ilus_Control-300x296.png 300w\" sizes=\"(max-width: 378px) 100vw, 378px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-5e0147a\" data-id=\"5e0147a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-8c1c0a0 elementor-widget elementor-widget-text-editor\" data-id=\"8c1c0a0\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>Semanas: 11 a 13 \/ 16 a 18 \/ 20 a 24<\/p><p>Para evaluar la anatom\u00eda fetal, miembros, articulaciones, paladar, otras anomal\u00edas.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8783635 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"8783635\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.8.1 - 13-11-2022 *\/\n.elementor-widget-divider{--divider-border-style:none;--divider-border-width:1px;--divider-color:#2c2c2c;--divider-icon-size:20px;--divider-element-spacing:10px;--divider-pattern-height:24px;--divider-pattern-size:20px;--divider-pattern-url:none;--divider-pattern-repeat:repeat-x}.elementor-widget-divider .elementor-divider{display:-webkit-box;display:-ms-flexbox;display:flex}.elementor-widget-divider .elementor-divider__text{font-size:15px;line-height:1;max-width:95%}.elementor-widget-divider .elementor-divider__element{margin:0 var(--divider-element-spacing);-ms-flex-negative:0;flex-shrink:0}.elementor-widget-divider .elementor-icon{font-size:var(--divider-icon-size)}.elementor-widget-divider .elementor-divider-separator{display:-webkit-box;display:-ms-flexbox;display:flex;margin:0;direction:ltr}.elementor-widget-divider--view-line_icon .elementor-divider-separator,.elementor-widget-divider--view-line_text .elementor-divider-separator{-webkit-box-align:center;-ms-flex-align:center;align-items:center}.elementor-widget-divider--view-line_icon .elementor-divider-separator:after,.elementor-widget-divider--view-line_icon .elementor-divider-separator:before,.elementor-widget-divider--view-line_text .elementor-divider-separator:after,.elementor-widget-divider--view-line_text .elementor-divider-separator:before{display:block;content:\"\";border-bottom:0;-webkit-box-flex:1;-ms-flex-positive:1;flex-grow:1;border-top:var(--divider-border-width) var(--divider-border-style) var(--divider-color)}.elementor-widget-divider--element-align-left .elementor-divider .elementor-divider-separator>.elementor-divider__svg:first-of-type{-webkit-box-flex:0;-ms-flex-positive:0;flex-grow:0;-ms-flex-negative:100;flex-shrink:100}.elementor-widget-divider--element-align-left .elementor-divider-separator:before{content:none}.elementor-widget-divider--element-align-left .elementor-divider__element{margin-left:0}.elementor-widget-divider--element-align-right .elementor-divider .elementor-divider-separator>.elementor-divider__svg:last-of-type{-webkit-box-flex:0;-ms-flex-positive:0;flex-grow:0;-ms-flex-negative:100;flex-shrink:100}.elementor-widget-divider--element-align-right .elementor-divider-separator:after{content:none}.elementor-widget-divider--element-align-right .elementor-divider__element{margin-right:0}.elementor-widget-divider:not(.elementor-widget-divider--view-line_text):not(.elementor-widget-divider--view-line_icon) .elementor-divider-separator{border-top:var(--divider-border-width) var(--divider-border-style) var(--divider-color)}.elementor-widget-divider--separator-type-pattern{--divider-border-style:none}.elementor-widget-divider--separator-type-pattern.elementor-widget-divider--view-line .elementor-divider-separator,.elementor-widget-divider--separator-type-pattern:not(.elementor-widget-divider--view-line) .elementor-divider-separator:after,.elementor-widget-divider--separator-type-pattern:not(.elementor-widget-divider--view-line) .elementor-divider-separator:before,.elementor-widget-divider--separator-type-pattern:not([class*=elementor-widget-divider--view]) .elementor-divider-separator{width:100%;min-height:var(--divider-pattern-height);-webkit-mask-size:var(--divider-pattern-size) 100%;mask-size:var(--divider-pattern-size) 100%;-webkit-mask-repeat:var(--divider-pattern-repeat);mask-repeat:var(--divider-pattern-repeat);background-color:var(--divider-color);-webkit-mask-image:var(--divider-pattern-url);mask-image:var(--divider-pattern-url)}.elementor-widget-divider--no-spacing{--divider-pattern-size:auto}.elementor-widget-divider--bg-round{--divider-pattern-repeat:round}.rtl .elementor-widget-divider .elementor-divider__text{direction:rtl}.e-con-inner>.elementor-widget-divider,.e-con>.elementor-widget-divider{width:var(--container-widget-width,100%)}<\/style>\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-297b3ca elementor-widget elementor-widget-text-editor\" data-id=\"297b3ca\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>Ulteriores: Mensual o seg\u00fan cada caso<\/p><p>Para control de volumen de l\u00edquido amni\u00f3tico, movimiento y crecimiento fetales y posici\u00f3n de las articulaciones, para detectar artrogriposis.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-8132a99 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"8132a99\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-25df591\" data-id=\"25df591\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-71609ba elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"71609ba\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-37493cc\" data-id=\"37493cc\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-bdc993f elementor-widget elementor-widget-heading\" data-id=\"bdc993f\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">DURANTE EL PARTO<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a18e0c5 elementor-widget elementor-widget-text-editor\" data-id=\"a18e0c5\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>De preferencia, el parto deber\u00eda ser por v\u00eda vaginal, reservando la ces\u00e1rea para indicaciones obst\u00e9tricas. Puede emplearse el bloqueo epidural.<sup>1<\/sup><span style=\"color: var( --e-global-color-text );\">\u00a0<\/span><\/p><p>El m\u00fasculo liso uterino no se ve afectado; si las contracciones de los m\u00fasculos abdominales no son suficientemente efectivas, puede requerirse parto asistido.<sup>1<\/sup><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-2bab89c elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2bab89c\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-66468f0\" data-id=\"66468f0\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-cd6bc70 elementor-widget elementor-widget-heading\" data-id=\"cd6bc70\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">POSPARTO<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-438c4dd elementor-widget elementor-widget-text-editor\" data-id=\"438c4dd\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>Puede haber empeoramiento de la miastenia en las semanas posteriores al parto.<sup>1,2<\/sup><br \/><strong>La lactancia materna es segura. Solamente debe evitarse: 1)<\/strong> en caso de miastenia neonatal, porque los ACRA pueden ser transferidos a trav\u00e9s de la leche materna y, <strong>2)<\/strong> si la madre recibe azatioprina, micofenolato mofetil o ciclofosfamida.<sup>1<\/sup><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-bede18b elementor-section-height-min-height elementor-section-boxed elementor-section-height-default elementor-section-items-middle\" data-id=\"bede18b\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-8a20bab\" data-id=\"8a20bab\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-adb3313 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"adb3313\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-6a28529\" data-id=\"6a28529\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-c783960 elementor-widget elementor-widget-heading\" data-id=\"c783960\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">MIASTENIA NEONATAL<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5aa263e elementor-widget elementor-widget-text-editor\" data-id=\"5aa263e\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>El riesgo de miastenia neonatal es mayor en las mujeres con exacerbaciones de la MG, aquellas sin tratamiento o no timectomizadas.<sup>1<\/sup><span style=\"color: var( --e-global-color-text );\">\u00a0<\/span><\/p><p>Los s\u00edntomas neonatales aparecen generalmente el primer d\u00eda y hasta los primeros 7 d\u00edas. Usualmente son leves o moderados: ptosis palpebral, dificultad para mamar, llanto d\u00e9bil, hipoton\u00eda generalizada. Es infrecuente que se requiere asistencia ventilatoria o sonda nasog\u00e1strica.<sup>1,2<\/sup><\/p><p>La condici\u00f3n es transitoria y remite espont\u00e1neamente. En tres semanas, los anticuerpos ACRA maternos son eliminados de la circulaci\u00f3n del reci\u00e9n nacido.<sup>1<\/sup><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-396cc46\" data-id=\"396cc46\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5829fbd elementor-widget elementor-widget-image\" data-id=\"5829fbd\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"412\" height=\"412\" src=\"https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Layer-13.png\" class=\"attachment-full size-full\" alt=\"\" loading=\"lazy\" srcset=\"https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Layer-13.png 412w, https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Layer-13-300x300.png 300w, https:\/\/centrodemiastenia.com\/medicos\/wp-content\/uploads\/sites\/3\/2022\/10\/Layer-13-150x150.png 150w\" sizes=\"(max-width: 412px) 100vw, 412px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<div class=\"elementor-element elementor-element-eac28ae elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"eac28ae\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f7c0628 elementor-widget elementor-widget-text-editor\" data-id=\"f7c0628\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><strong>Referencias: 1<\/strong>. Cimpoca-Raptis BA, Ciobanu AM, Gica N, Peltecu G, et al. Fetal surveillance in pregnancies with myasthenia gravis. Medicina 2021;57:1277. <strong>2.<\/strong> Pascuzzi R, Bodkin CL. Chapter 53. Disorders of the neuromuscular junction. En: Jos\u00e9 Biller. Practical Neurology Fifth edition. Philadelphia: Wolters Kluwer; 2017. p. 685-696. <\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Miastenia y embarazo Desde el punto de vista de la salud materno-fetal, la miastenia gravis es compatible con el embarazo y no hay motivo para desalentar la concepci\u00f3n. Sin embargo, se considera que el embarazo es de alto riesgo en las mujeres con miastenia debido a que puede tener resultados adversos, y es necesario el [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"inline_featured_image":false},"_links":{"self":[{"href":"https:\/\/centrodemiastenia.com\/medicos\/wp-json\/wp\/v2\/pages\/643"}],"collection":[{"href":"https:\/\/centrodemiastenia.com\/medicos\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/centrodemiastenia.com\/medicos\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/centrodemiastenia.com\/medicos\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/centrodemiastenia.com\/medicos\/wp-json\/wp\/v2\/comments?post=643"}],"version-history":[{"count":37,"href":"https:\/\/centrodemiastenia.com\/medicos\/wp-json\/wp\/v2\/pages\/643\/revisions"}],"predecessor-version":[{"id":1012,"href":"https:\/\/centrodemiastenia.com\/medicos\/wp-json\/wp\/v2\/pages\/643\/revisions\/1012"}],"wp:attachment":[{"href":"https:\/\/centrodemiastenia.com\/medicos\/wp-json\/wp\/v2\/media?parent=643"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}