Background Hypertensive disorders of pregnancy increase future cardiovascular risk. The Clinique Santé Globale PostPartum (CSGPP) was created to assess risk, provide lifestyle counseling, and inform primary care providers. This study was meant to assess its relevance, efficacy, and women's satisfaction to optimize the clinic. Methods This descriptive, single-center prospective cohort study was conducted at the Centre Hospitalier Universitaire de Sherbrooke. Women were recruited at their first CSGPP visit. Data on attendance, lifestyle behaviors, motivation, follow-up with primary care providers, and satisfaction were collected at baseline and 12 months postpartum. Results Of 104 referrals, 84 women (80.8%) attended the first visit, 65 agreed to participate, and 47 completed follow-up. Belief in the health benefits of lifestyle changes increased ( P = .007), and satisfaction with the clinic was high. Conclusion Given the high adherence and satisfaction with the clinic, these findings support expanding access to the clinic to all conditions increasing CVD in this young population.
Intrahepatic cholestasis of pregnancy (ICP) is associated with significant maternal morbidity and fetal risk. We describe a 31-year-old primiparous patient with quiescent systemic lupus erythematosus and lupus nephritis on azathioprine, hydroxychloroquine, and tacrolimus who developed generalized pruritus at 29 weeks. Workup showed markedly elevated bile acids (234 µmol/L) with mild alanine aminotransferase elevation. She was diagnosed with ICP and started on ursodiol and hydroxyzine, but symptoms persisted. Given reports of thiopurine-associated cholestasis, the medication was discontinued, and 6-methylmercaptopurine levels were found to be supratherapeutic. Within days, bile acids and pruritus improved, with normalization over three weeks. She remained asymptomatic, delivered at 36 weeks, and later resumed azathioprine without issue. We summarize 17 cases of thiopurine-associated cholestasis, typically with early onset, severe bile acid elevation, and poor response to ursodiol. This case highlights the importance of medication review, and assessment for possible secondary contributors in atypical or refractory ICP presentations.
Introduction There is limited information on the impact of pregnancy planning on neonatal outcomes in people with spina bifida (SB). Methods This study is a sub-group analysis of The Spina Bifida Reproductive Health and Pregnancy Study, an online international cross-sectional survey. Pregnancy, birth and neonatal data were assessed using descriptive and chi-squared analyses. Results A total of 209 pregnancies were included: 108 planned and 101 unplanned. The unplanned group included a greater risk of miscarriage/ectopic pregnancy (30%), unplanned fetal loss (34%), intrauterine growth restriction less than 5th percentile (16%) and babies with congenital anomalies. There was no statistically significant difference between unplanned and planned pregnancies in terms of admission to neonatal intensive care unit or risk of preterm birth. Conclusion People with SB have rates of unplanned pregnancy similar to the general population. Unplanned pregnancies appear to have increased fetal and neonatal risks. Findings suggest that pregnancy planning is a modifiable factor, which may improve outcomes.
Belly dancer dyskinesia (BDD) is a rare movement disorder characterized by involuntary, repetitive contractions of the abdominal wall. Pregnancy-associated BDD is exceptionally uncommon, and recurrence in subsequent pregnancies has rarely been reported. We describe the case of a 29-year-old woman in her first pregnancy who developed involuntary abdominal movements at 16 weeks. Her medical history included hypertension and multiple uterine fibroids. Neurological assessment, laboratory investigations, and spinal magnetic resonance imaging were unremarkable, and a clinical diagnosis of BDD was established. Symptoms persisted throughout pregnancy and resolved immediately after delivery. Two years later, during a second pregnancy, similar movements recurred at 15 weeks, again resolving completely after delivery. Recurrence during two consecutive pregnancies suggests a pregnancy-related trigger for BDD, and complete postpartum resolution highlights the self-limiting course of this benign condition.
