Reproductive System - DM1


  • The deleterious effects of DM1 on both smooth and striated muscle can complicate pregnancy, labor and delivery.

  • Added to these maternal complications is the possibility that the baby may have congenital-onset DM1, with severe neonatal complications, including respiratory and swallowing abnormalities.

  • Women with DM1 have a higher than average rate of spontaneous abortion and stillbirth, although most can expect to have a normal vaginal delivery.


  • Mothers with DM1 are more likely than the general population to experience the following:

    • Ectopic pregnancy.

    • Premature delivery.

    • Prolonged labor and delivery.

    • Postpartum hemorrhage.

    • Uterine over distention with polyhydramnios which can lead to preterm labor, inadequate contractions during labor, premature rupture of the membranes or postpartum hemorrhage.

    • Untoward reactions to analgesia or anesthesia during labor and delivery.

    • Diminished ovarian reserve with delayed appearance of human chorionic gonadotropin (HCG) due to gonadal insufficiency.

  • Reproductive history and DM1-related personal and family history, including current DM1 symptoms.

  • Fatigue with more rapid onset than average during labor and increased risk of post-partum hemorrhage (PPH).


  • Discuss the following tests with your doctor:

    • Preimplantation genetic diagnosis to determine whether the embryo is affected.

    • Prenatal genetic diagnosis to determine if the fetus has the DM1 genetic expansion (see Genetic counseling).


  • Preimplantation genetic diagnosis can allow selective implantation of unaffected embryos.

  • Prenatal diagnosis by amniocentesis or chorionic villus sampling can allow for termination of an affected pregnancy.

  • High-risk obstetrician (Maternal-fetal medicine specialist) for prenatal care and delivery.

  • Analgesics or sedating anesthetic drugs should be used extremely.

  • Emergency medical alert devices.

  • Pediatric or neonatal specialist at delivery if the mother is affected with DM1.

  • Availability of neonatal intensive care, including possible tube feeding or ventilatory support, for neonates known, or suspected to have DM1.

  • Consulting obstetrician before a decision to induce labor is made.

  • Genetic counseling services and family planning services.

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