Guillain-Barré syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy affecting the peripheral nervous system, with a range of clinical presentations. GBS in pregnancy is rare and creates diagnostic and management challenges, with limited evidence to guide decisions on the timing and mode of delivery. We report a case of a 37-year-old gravida 4, para 3, who presented at 34+3 weeks of gestation with progressive lower limb weakness, sensory loss, and urinary incontinence. She had received a respiratory syncytial virus (RSV) vaccine shortly before the onset of symptoms. Neurological evaluation, including lumbar puncture and nerve conduction studies, supported a diagnosis of GBS with cranial nerve involvement. The patient was managed with intravenous immunoglobulin (IVIG), physiotherapy, and coordinated multidisciplinary obstetric and anesthetic care. She underwent induction of labor at 37+2 weeks and achieved a spontaneous vaginal delivery of a healthy infant. After delivery, maternal neurological function improved with ongoing physiotherapy. This report highlights the importance of early recognition of GBS in pregnancy, the role of a multidisciplinary team (MDT) in management, and the feasibility of vaginal delivery in appropriately selected patients.
Baloch et al. (Mon,) studied this question.