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免疫性または遺伝性神経筋疾患を有する女性が妊娠をすることがしばしばある。免疫性疾患,遺伝性疾患ともに妊娠中に増悪する可能性がある。妊娠中の疾患活動性コントロールは,妊娠転帰に関わる重要な要素であり,リスク・ベネフィットを勘案して症例ごとに治療薬を検討する。近年,生物学的製剤や核酸医薬品などの新規治療薬が次々と開発され,多くの患者が恩恵を受けているが,妊婦に対する安全性のエビデンス集積が課題となる。
Abstract
Women of childbearing age can develop autoimmune or hereditary neuromuscular disorders, which can exacerbate during pregnancy. Stabilizing disease activity during pregnancy has a positive impact on pregnancy and delivery outcomes. Selection of therapeutic agents during pregnancy should be based on the evaluation of the risks and benefits involved. Generally, spontaneous vaginal delivery is recommended; however, preterm and emergency cesarean deliveries may become necessary. Novel agents such as biologics and nucleic acid drugs have been introduced in clinical practice in recent years. These novel agents have provided significant benefit to patients with neuromuscular disorders, although verification of their safety profile in pregnant women is an important issue that should be addressed.
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