Pregnancy with mitochondrial disease complicated by threatened preterm labor and preeclampsia

抄録

Mitochondrial disease exhibits various symptoms and is rarely seen in young women. We report the case of a patient with mitochondrial disease complicated with maternal inherited diabetes-deafness (MIDD) who suffered a severe clinical course. A 33-year-old primipara woman had a history of diabetes, diagnosed when she was 18 years old, and was treated with insulin injection. At 24 years old, genetic testing was performed and a point mutation of mitochondrial DNA in m3243 was identified. She was admitted to our hospital at 23 weeks of gestation because of threatened preterm labor and was treated with magnesium sulfate infusion. General malaise developed shortly after and the tocolytic agent was changed to ritodrine hydrochloride. She developed preeclampsia at 33 weeks of gestation and an emergency cesarean section was performed. After the cesarean section, UAE was performed due to uterine hemorrhage after birth and, because of infection, a hysterectomy was performed. An increased risk of preeclampsia, preterm birth and magnesium toxicity has been reported in pregnancies complicated with mitochondrial disease. Obstetricians need to recognize this disease as a perinatal risk factor.