Bernard-Soulier syndrome in pregnancy with retinal detachment: a rare phenomenon.

Bernard-Soulier syndrome (BSS) is a rare congenital bleeding disorder of the platelet, and it is mainly inherited as an autosomal recessive trait. It is caused by both qualitative and quantitative deficiency of the platelet membrane glycoprotein (GP) Ib-IX-V receptor complex, thereby causing abnormal platelets adhesion.We report a case of a primigravida in her 20s with history of BSS diagnosed in childhood due to family history. Her preconception period was challenging as she suffered from severe menorrhagia often requiring hospital admission, blood and platelet transfusions.At 35 weeks gestation, she developed temporal crowded retinal detachment of the left eye and had a successful left scleral buckling surgery under general anaesthesia (GA).She had a multidisciplinary team care with a successful elective GA caesarean section at 39+3 weeks gestation with peridelivery platelet transfusion and intravenous recombinant factor VIIa. Regional anaesthesia, intramuscular injections and anticoagulation were avoided.

Pregnancy-associated spontaneous coronary artery dissection: multidisciplinary management, challenges and literature review.

A 30-year-old woman in her second pregnancy, which was complicated by gestational diabetes mellitus. She had an uneventful spontaneous vaginal delivery at 38 weeks+3 days of gestation. Day 1 postpartum, she developed sudden chest pain radiating to her jaw and neck. Her observations were normal, and ECG showed lateral ST elevation in keeping with acute myocardial infarction. The troponin-T level was elevated at 21 ng/L at 0 hour, and >10 000 ng/L at 12 hours, respectively. Coronary angiography confirmed spontaneous dissection of the proximal left anterior descending (LAD) and proximal circumflex coronary arteries. She became unstable during percutaneous coronary intervention and consequently had a successful coronary artery bypass surgery with left saphenous vein grafts to the first obtuse marginal artery and LAD. Echocardiogram revealed moderate to severe impairment of the left ventricular function postoperatively.

Successful management of fetal atrial flutter at term pregnancy with postnatal electrocardioversion.

Fetal atrial flutter is a lethal tachyarrhythmia with a 10% mortality rate. Diagnosis is made with echocardiography, and management should be multidisciplinary with obstetricians, fetal cardiologists, and specialist neonatologists.

Placenta accreta after postpartum tubal sterilisation and Novasure® endometrial ablation.

Although rare, pregnancy can still occur after both tubal sterilization and endometrial ablation. The resulting pregnancy is often complicated by ectopic pregnancy, miscarriage, and adherent placenta. Endometrial ablation is not a contraceptive.