Valproate-induced hyperammonemia - uncovering an underlying inherited metabolic disorder: a case report.

Background: Sodium valproate is a commonly used anticonvulsant. It is widely recognized that valproate can cause hyperammonemia, particularly in people with underlying liver disease. Patients with urea cycle disorders are genetically predisposed to this adverse event and can develop severe hyperammonemia if given valproate.

Pregnancy outcomes in women greater than 45 years: a cohort control study in a multi-ethnic inner city population.

Objective: To examine the pregnancy outcomes of women >45 years in a multi-ethnic population when compared to controls and to reflect on socio-demographic details of the older mothers.

Design: A retrospective cohort control study over an 8-year period in an inner city London hospital with multi-ethnic population. The influence of advanced maternal age (>45 years at time of delivery) on fetal and maternal outcomes was assessed by comparing these women to controls (aged 20-30 years) matched for ethnicity, country of origin and parity.