Survey of Raspberry Leaf Tea in pregnancy.

BACKGROUND: Raspberry leaf tea (RLT) is a traditional herb purported to help with many pregnancy-related outcomes including reducing the duration of labour. No experimental data exist to support these claims. AIMS: This study aims to determine how common use and knowledge of RLT are during pregnancy. It also aims to explore whether it would be possible to recruit women for a trial of raspberry leaf in the future. MATERIALS AND METHODS: Postnatal women were asked to fill in a survey about their use of RLT during pregnancy, and their knowledge of its purported benefits. They were asked whether they would consider being part of a randomised controlled trial of raspberry leaf in the future. RESULTS: One hundred and twenty-one women completed the survey. Of these, 88 (73%) were aware of herbal tea use in pregnancy and 46 (38%) reported using raspberry leaf during pregnancy. Of all women surveyed, 79% indicated they would be happy to participate in a trial of RLT in pregnancy if they were asked. CONCLUSIONS: Despite no scientific evidence of the efficacy of RLT in pregnancy, 38% of women surveyed used it during pregnancy. Further studies are required to determine whether the claims made about RLT are correct. Clinicians should base their advice on available evidence.

Antenatal and postnatal radiologic diagnosis of holocarboxylase synthetase deficiency: a systematic review.

BACKGROUND: Holocarboxylase synthetase deficiency results in impaired activation of enzymes implicated in glucose, fatty acid and amino acid metabolism. Antenatal imaging and postnatal imaging are useful in making the diagnosis. Untreated holocarboxylase synthetase deficiency is fatal, while antenatal and postnatal biotin supplementation is associated with good clinical outcomes. Although biochemical assays are required for definitive diagnosis, certain radiologic features assist in the diagnosis of holocarboxylase synthetase deficiency. OBJECTIVE: To review evidence regarding radiologic diagnostic features of holocarboxylase synthetase deficiency in the antenatal and postnatal period. MATERIALS AND METHODS: A systematic review of all published cases of holocarboxylase synthetase deficiency identified by a search of Pubmed, Scopus and Web of Science. RESULTS: A total of 75 patients with holocarboxylase synthetase deficiency were identified from the systematic review, which screened 687 manuscripts. Most patients with imaging (19/22, 86%) had abnormal findings, the most common being subependymal cysts, ventriculomegaly and intraventricular hemorrhage. CONCLUSION: Although the radiologic features of subependymal cysts, ventriculomegaly, intraventricular hemorrhage and intrauterine growth restriction may be found in the setting of other pathologies, these findings should prompt consideration of holocarboxylase synthetase deficiency in at-risk children.

Heterotopic pregnancy: a report of two cases.

Background: A heterotopic pregnancy is defined as the presence of a concomitant intrauterine and extrauterine pregnancy. Its estimated incidence is 1/30,000 in spontaneous pregnancies. It is also reported to be as high as 1 in 3900 when the pregnancy is a result of assisted reproductive technology (ART). However, clomiphene citrate (CC) could be associated with a higher rate of heterotopic pregnancy as it amplifies the rate of twinning. Furthermore, heterotopic pregnancies are a diagnostic and therapeutic challenge for obstetricians. If undiagnosed, they are associated with significant maternal morbidity and mortality. Case presentation: We present two cases of coincidental intra and extra-uterine pregnancy. In the first case, heterotopic pregnancy was a result of induction of ovulation with CC. There was a delay in the diagnosis of the ectopic pregnancy component resulting in an emergency laparoscopy. Fortunately, after the laparoscopy the intrauterine pregnancy was not affected and it is progressing satisfactorily. Alternatively, the second case occurred spontaneously and was treated with methotrexate as the intrauterine pregnancy miscarried on its own accord. Conclusions: These cases highlight the fact that as clinicians, we should be aware of the possibility of a heterotopic pregnancy in any patient presenting with pelvic pain, even when an intrauterine pregnancy has been confirmed. This is even more imperative after induction of ovulation by CC or ART. We would also like to emphasise that an early diagnosis is critical to safeguard the intrauterine pregnancy and avoid maternal morbidity and mortality due to the ectopic pregnancy.

The value of early recognition of fetal lymphangioma.

Introduction: Lymphangiomas are very rare benign tumors of the lymphatic system, appearing as uniseptate or multiseptate cystic masses, which are usually located in the cervical or axillary area. Postnatal outcome depends on the size and location of the lesion. An increasing number of such congenital abnormalities are detected on routine conventional prenatal ultrasonography. Although prenatal evaluation for the prognosis of fetal lymphangioma has been based on two-dimensional ultrasonography, magnetic resonance imaging may help in assessing the extent of a lesion. Isolated lymphangiomas generally have a favourable prognosis and sclerotherapy or surgical resection is effective in most of the cases. Case presentation: We present two cases of fetal axillary lymphangioma. In the first case, the lymphangioma was diagnosed antenatally, so parents were comprehensively counselled and post natal follow up was organised at a tertiary hospital. The second case remained undiagnosed until birth. This caused significant distress to both the parents and clinicians, especially after a coincident traumatic delivery. Conclusion: Both these cases emphasise that early diagnosis of fetal lymphangioma is critical and a combination of ultrasonography and magnetic resonance imaging can facilitate detection of lesions which are relatively limited and accessible to therapy in utero. This would also enable clinicians to perform a karyotype and comprehensively consult parents regarding the treatment and delivery options as well as outcome of the pregnancy.