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While dantrolene can be given to a pregnant woman, it does cross the placenta and there are side effects in the neonate. This again is just a risk and would have to be weighed against the expected benefit. Weakness in the neonate might be expected and must be looked for and treated appropriately. An article published in 1988 suggests that at low dose, there are no problems. (Am J Obstet Gynecol., Oct 1988;159(4):831-4.
Epidurals are safe for MH affected individuals and safe for the baby as well. All measures should be taken to decrease your stress during labor and delivery.
All local anesthetics are safe.
See Also: Safe and Unsafe Anesthetics
There is no report of an MH reaction occurring during labor and delivery unless triggering general anesthetic agents are given. You need not worry about this happening while you are asleep naturally. The pain management you will receive is very safe.
No – deliver the baby vaginally if recommended by your obstetrician. There are many risks other than MH associated with anesthesia for the C-section, the mother and the baby. Vaginal delivery with labor analgesia is perfectly safe for the MH-susceptible patient.
No, just remind the staff that you are MH susceptible when you arrive in the labor suite.
We have to assume your child is susceptible; but, as long as you are receiving safe anesthesia, your baby is not at risk either. Of interest, there are very few reports of infants triggering with MH, even when an individual is later proven to have MH. MH-susceptible baby pigs do not trigger consistently either. There is apparently some protection offered by immaturity. Your baby boy will not be at risk with the epidural or from local anesthesia used for the circumcision.
Your internist is advising you well, but very conservatively. Some anti-psychotic agents cause a condition called neuroleptic malignant syndrome (NMS), which looks something like MH but has a different underlying cause. Nonetheless, the conservative approach is to avoid this class of drugs in MH-affected patients. Phenergan is used for nausea in the hospital; it is unlikely you would need it, but it would be reasonable to avoid this class. The drugs used for labor analgesia are safe.
See Also: NMSIS Website