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We describe the case of a 40-year-old patient who sustained an aortic transection in 2016 following a road traffic accident and had two subsequent full-term pregnancies. This case adds to the literature on pregnancy after endovascular aortic repair. [ABSTRACT FROM AUTHOR]

We present the case of a healthy nulliparous woman who presented with persistent fever, proteinuria and elevated transaminases at 33 weeks' gestation. Following initial treatment for suspected chorioamnionitis and potential pre-eclampsia, she had a caesarean section delivering a healthy male infant. However, on her third post-operative day, she developed neurological symptoms and accompanying severe sepsis, necessitating inotropic support and transfer to a higher level of care. A comprehensive work-up revealed herpes simplex Virus-2 (HSV-2) in serum and cerebrospinal fluid. Abdominal imaging was suggestive of accompanying hepatitis with micro-abscesses. This lady recovered well following intravenous acyclovir for 14 days. Her infant was not affected and was discharged home with his mother. Herpes simplex encephalitis and hepatitis associated with HSV-2 have been described three times previously in pregnancy. We delineate the diagnostic challenges that rare conditions such as this pose and emphasise the importance of multi-disciplinary care in managing complicated medical conditions in pregnancy. [ABSTRACT FROM AUTHOR]

The comorbid presentation of anti-NMDAR encephalitis with ovarian teratomas was first described in 2005. The incidence of anti-NMDAR encephalitis during pregnancy is rare, with 16 cases reported to date. We describe the case of a 31-year-old nulliparous woman who presented with status epilepticus in early pregnancy and was subsequently diagnosed with anti-NMDAR encephalitis. The inter-hospital transfer was required for higher-level care and ventilation. A comprehensive work-up identified anti-NMDAR antibodies in both serum and cerebrospinal fluid. Pelvic imaging showed a unilateral ovarian cyst, proceeding to right salpingo-oophorectomy and cystectomy of a mature cystic teratoma. Post-operatively, she was admitted to the intensive care unit for two months. Immunotherapy was commenced, and clinical status improved. She recovered well and at 35 weeks and 2 days of gestation delivered a live male infant via uncomplicated caesarean section. We discuss the diagnostic steps and multi-disciplinary management to care for this pregnant patient. [ABSTRACT FROM AUTHOR]

Ebola viral disease’s interaction with pregnancy is poorly understood and remains a particular challenge for medical and para-medical personnel responding to an outbreak. This review article is written with the benefit of hindsight and experience from the largest recorded Ebola outbreak in history. We have provided a broad overview of the issues that arise for pregnant women and for the professionals treating them during an Ebola outbreak. The discussion focuses on the specifics of Ebola infection in pregnancy and possible management strategies, including the delivery of an infected woman. We have also discussed the wider challenges posed to pregnant women and their carers during an epidemic, including the identification of suspected Ebola-infected pregnant women and the impact of the disease on pre-existing health services. This paper outlines current practices in the field, as well as highlighting the gaps in our knowledge and the paramount need to protect the health-care workers directly involved in the management of pregnant women. [ABSTRACT FROM AUTHOR]

The UK confidential enquiry into maternal deaths identified poor management of medical problems in pregnancy to be a contributory factor to a large proportion of indirect maternal deaths. Maternal (obstetric) medicine is an exciting subspecialty that encompasses caring for both women with preexisting medical conditions who become pregnant, as well as those who develop medical conditions in pregnancy. Obstetrics and gynaecology trainees have some exposure to maternal medicine through their core curriculum and can then complete an advanced training skills module, subspecialise in maternal-fetal medicine or take time out to complete the Royal College of Physicians membership examination. Physician training has limited exposure to medical problems in pregnancy and has therefore prompted expansion of the obstetric physician role to ensure physicians with adequate expertise attend joint physician-obstetrician clinics. This article describes the role of an obstetric physician in the UK and the different career pathways available to physicians and obstetricians interested in maternal medicine. [ABSTRACT FROM AUTHOR]

Cerebral neoplasms are uncommon in pregnancy but should be considered in any pregnant woman with new onset neurological symptoms and signs. We report a case of cerebellar haemangioblastoma presenting in pregnancy and discuss the clinical presentation, diagnosis, surgical management and medical literature surrounding the condition. [ABSTRACT FROM AUTHOR]