{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T11:23:36Z","timestamp":1793618616438,"version":"4.5.0"},"reference-count":17,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,6,15]]},"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:p>A primigravida in mid 30s presented to hospital at 30+2 weeks gestation, due to progressive neurological symptoms including ascending limb weakness and paraesthesia bilaterally as well as dysphagia, facial weakness and dysphasia.<\/jats:p>\n               <jats:p>The patient was diagnosed with Guillain-Barr\u00e9 syndrome after physical examination and electromyography, which showed a patchy demyelinating sensorimotor polyneuropathy. The patient underwent a 5-day course of intravenous immunoglobulin, beginning the day after admission. Markers of severity including forced vital capacity improved thereafter until delivery.<\/jats:p>\n               <jats:p>With limited evidence favouring one particular anaesthetic technique in parturients with Guillain-Barr\u00e9 syndrome, combined spinal epidural anaesthesia was preferred over general anaesthesia in order to avoid the potential for prolonged intubation postoperatively and to allow careful titration of neuraxial blockade. Delivery by caesarean section at 34+1 weeks due to pre-eclampsia was uncomplicated. Thereafter the patient\u2019s condition deteriorated, requiring a further 5-day course of intravenous immunoglobulin with symptoms gradually improving over a 6-month admission.<\/jats:p>","DOI":"10.1136\/bcr-2024-260285","type":"journal-article","created":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T22:45:37Z","timestamp":1719441937000},"page":"e260285","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Caesarean section for a primipara with Guillain-Barr\u00e9 syndrome under combined spinal epidural anaesthesia"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7393-9866","authenticated-orcid":false,"given":"Shoko","family":"Okahara","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Pain Medicine, Fiona Stanley and Fremantle Hospitals Group, Perth, Western Australia, 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