Guillain-Barre Syndrome in Pregnancy

Guillain-Barre syndrome has been reported in pregnancy and is a potentially lethal condition. It affects the nervous system with acute onset of symmetric ascending weakness and may result in frank respiratory failure and autonomic dysfunction. Most patients recall symptoms of a respiratory or gastrointestinal illness in the weeks preceding the onset of weakness. Recent evidence suggests a potential role of the Zika virus as a trigger for the syndrome. The diagnosis of Guillain-Barre is clinical. Supportive measures include venous thromboembolism prophylaxis, aggressive physical therapy, pressure ulcer prevention, enteral nutrition, and respiratory support. The mainstay of management comprises plasmapheresis or administration of intravenous immunoglobulins. Affected patients must be closely monitored for development of respiratory failure and autonomic dysfunction. Treatment during pregnancy should follow the same principles as for nonpregnant individuals.