Myotonic dystrophy and pregnancy.

Myotonic dystrophy is the most common neuromuscular disease in adults with a prevalence of 2.4-5.5 per 100,000. Here we describe two cases of DM and discuss their obstetric complications. Our first case concerns a 39 year old multipara whose pregnancies were complicated by recurrent abdominal pain, polyhydramnios and post partum haemorrhage which was attributed to DM. In our second case we discuss the management of a 27 year old woman with dichorionic, di-amniotic twins. Chorionic Villous Sampling at 11 weeks revealed one of the fetuses, a male; to be afflicted by DM. Selective termination of the affected twin was performed. Unfortunately, she developed severe oligohydramnios and chronic liquor leak. This resulted in the intra-uterine death of the second twin 5 days later. Our cases highlight the importance of prenatal diagnosis and prompt genetic counselling. A multidisciplinary team approach is required in the management of such high risk cases.