Obstetric Complications as the First Sign of Myotonic Dystrophy

Abstract

A patient with undiagnosed myotonic dystrophy presented in pregnancy with a history of severe obstetric and neonatal complications in her two previous pregnancies. Problems arising after cesarean section led to the diagnosis of myotonic dystrophy. The features of this condition and its implications for pregnancy are pointed out. Complications of pregnancy and parturition may be the first symptoms of myotonic dystrophy.

Increased risk for abnormal placentation in women affected by myotonic dystrophy

“…Fetal and neonatal demise is high, especially due to the congenital form of myotonic dystrophy. Although obstetric complications may be the first symptoms leading to the diagnosis of the disease, as with 5 out of 6 patients in this series and in other reports [3], it should be possible to detect most patients prior to delivery, since relevant features (myopathic facies, hypernasal speech, cataracts, and grip myotonia) are mostly present from youth to early adulthood.…”

“…Three case reports of women with myotonic dystrophy and placenta accreta have been published [3,4], suggesting myotonic dystrophy as a causal factor of deep implantation leading to placenta accreta.…”

“…While an increased risk for obstetric complications is well known in women with the disorder, only rarely has the association of abnormal placentation and myotonic dystrophy been described [3,4]. Here we report the obstetric histories of six unrelated patients with myotonic dystrophy who each…”

“Shake hands”; Diagnosing a floppy infant – Myotonic dystrophy and the congenital subtype: a difficult perinatal diagnosis

“…28 (2000) MD in pregnant women causes a substantial risk for both mother and child. The mother is at risk of an increase in symptoms and rates of spontaneous abortion, premature delivery and neonatal death are increased [6,14]. Intrapartum complications occur at all stages of labor.…”

Évaluation du recours au test génétique chez les personnes à risque de la dystrophie myotonique au Saguenay-Lac-St-Jean

“…C'est d'ailleurs souvent à cette occasion que le diagnostic de DM est établi chez cette dernière (Fossen, 1986). La transmission presque exclusivement maternelle de la forme congénitale est encore aujourd'hui un processus mal défini.…”