ArticleGynecology and pelvic medicine2026
Limb-girdle muscular dystrophy type R2 manifesting as fetal growth restriction in a woman with two pregnancies: a case report.
Article in Gynecology and pelvic medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Limb-girdle muscular dystrophy (LGMD) is a rare inherited myopathy characterized by progressive weakness of the shoulder and pelvic girdle muscles. Limb-girdle muscular dystrophy type R2 (LGMD R2) caused by Case Description: A 28-year-old Asian woman with genetically confirmed LGMD R2, diagnosed at age 20 year, underwent two pregnancies managed by a multidisciplinary team (genetics, obstetrics, neurology). Management included enoxaparin (40 mg once daily), low-dose aspirin (100 mg daily initiated at 12 weeks), oral antihypertensives (labetalol ≤600 mg/day), and nutritional supplementation with high-protein diet and vitamins. This coordinated multidisciplinary team (MDT) approach ensured comprehensive, individualized, and continuous care throughout the patient's pregnancies. During the first pregnancy, the patient developed hepatic dysfunction [alanine aminotransferase (ALT) 152 U/L, aspartate aminotransferase (AST) 133 U/L], progressive FGR [estimated fetal weight (EFW) <3rd percentile], and pregnancy-induced hypertension (up to 165/102 mmHg), culminating in medically indicated termination at 34 Conclusions: LGMD R2 significantly increases the risks of FGR, preeclampsia, and ICP, with FGR representing a key challenge due to its direct impact on fetal outcomes. Successful management requires multidisciplinary coordination, early prophylactic strategies such as aspirin, and vigilant monitoring of fetal growth and placental function. Although LGMD is not an absolute contraindication for pregnancy, women face substantial maternal and fetal risks, and pregnancy may accelerate maternal muscle weakness. Individualized reproductive counseling-including consideration of early delivery or pregnancy termination in severe cases-is essential.
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