Mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) syndrome in pregnancy.

The syndrome of mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) is a rare mitochondrial disease with few documented cases in pregnancy. In this case report, we discuss the presentation and management of a 39-year-old grand multiparous lady with MELAS syndrome, which was diagnosed prior to her eighth pregnancy, discuss potential implications of the condition in pregnancy and summarise the current guidelines for the management of this rare condition.

21st century obstetrics: a 50-year-old nullip-walk in the park?

We discuss the case of a 50-year-old nulliparous woman who conceived after fertilisation. She had multiple medical comorbidities and presented an obstetric and medical challenge. She was carefully managed through pregnancy and had a successful outcome.

Cocooned by complications: fetal survival through placental adherence.

We report a case of a 31-year-old woman with 2 previous caesarean deliveries who presented a diagnostic dilemma. She underwent caesarean section where she was found to have a uterine scar dehiscence with an adherent placenta and required a hysterectomy. While individually representing high risk to the mother and/or fetus, the combination in this case protected the fetus.

Unusual trend in the prevalence of trisomy 13 in mothers aged 35 and older: A population based study of national congenital anomaly data.

Background: Trisomy 13 is one of the three autosomal trisomies compatible with viability. It is associated with structural anomalies, learning disability and poor survival. Advanced maternal age is the most frequently suggested risk factor.