Two women were not included in the study as they had a spontaneous abortion in the first trimester. Four patients presented exacerbations of the disease during pregnancy, no exacerbation occurred in eight patients and three patients presented their first symptoms of myasthenia gravis during pregnancy (without diagnosis at time of delivery). Concerning the eight patients without exacerbations of the disease during pregnancy, pregnancy was brought to term in 87.5% of the cases; five women were submitted to nonurgent caesarean section (62.5%); and epidural block was performed in six patients (75%). No complications related to anaesthesia learn more occurred in the peripartum period. Concerning

the four patients with exacerbations of the disease, pregnancy was brought to term in three cases (75%); three women were submitted to nonurgent caesarean section (75%); and epidural block was performed in three patients (75%). One patient underwent an uncomplicated thymectomy under general anaesthesia during pregnancy and, in the postpartum period, there Linsitinib ic50 was a myasthenic crisis in another patient. Concerning the three patients without a myasthenia gravis diagnosis at partum, one woman already being followed for presenting muscular weakness

had a vaginal delivery under epidural block, without complications; another patient, presenting discrete supine dyspnoea, was submitted to elective caesarean section under spinal block and developed severe dyspnoea that required mechanical ventilation and ICU admission; and in the remaining case, a woman presenting mild blurred vision was submitted to general anaesthesia, which resulted in delayed emergence, muscular weakness and LDK378 respiratory failure. Pregnancy went full term in all cases (100%). No newborn had a myasthenic crisis.\n\nConclusion Myasthenia gravis can interfere slightly with pregnancy and partum, although exacerbations of the disease occur frequently. Strict surveillance and therapeutic optimisation are crucial. In women with

controlled disease, caesarean section should be carried out only if there are obstetric reasons. Locoregional anaesthesia is preferred, mainly epidural block. A good multidisciplinary cooperation, specific precautions and surveillance can certainly contribute to an improved outcome in myasthenia gravis patients during the peripartum period. Eur J Anaesthesiol 2010;27:985-990″
“Ferrocenyl-based phosphine ligands [Fe1-PPh2(spacer)-2-NMe2CH2C5H3 (C5H5)] (spacer =1,4-phenylene (rac-1), 1,3-phenylene (rac-2), 4,4′-biphenylene (rac-3), 2,5-thienylene (rac-4)) were applied in the rhodium(I)-catalyzed hydroformylation of various olefins (styrene, allylbenzene and 1-hexene) with higher chemo- and regioselectivity than a rhodium(I) catalyst precursor alone. The different sigma-donor properties of rac-1-4 were elucidated by P-31H-I NMR spectroscopy of the corresponding selenides. (C) 2013 Elsevier B.V. All rights reserved.