Successful twin pregnancy in a patient with parkin-associated autosomal recessive juvenile parkinsonism.

BACKGROUND: Pregnancy in patients with Parkinson disease is a rare occurrence. To the best of our knowledge, the effect of pregnancy as well as treatment in genetically confirmed autosomal recessive juvenile parkinsonism (ARJP) has never been reported. Here, we report the first case of pregnancy in a patient with ARJP associated with a parkin gene mutation, ARJP/PARK2. CASE PRESENTATION: A 27-year-old woman with ARJP/PARK2 was diagnosed as having a spontaneous dichorionic/diamniotic twin pregnancy. Exacerbation of motor disability was noted between ovulation and menstruation before pregnancy as well as during late pregnancy, suggesting that her parkinsonism might have been influenced by fluctuations in the levels of endogenous sex hormones. During the organogenesis period, she was only treated with levodopa/carbidopa, although she continued to receive inpatient hospital care for assistance in the activities of daily living. After the organogenesis period, she was administered sufficient amounts of antiparkinsonian drugs. She delivered healthy male twins, and psychomotor development of both the babies was normal at the age of 2 years. CONCLUSION: Pregnancy may worsen the symptoms of ARJP/PARK2, although appropriate treatments with antiparkinsonian drugs and adequate assistance in the activities of daily living might enable successful pregnancy and birth of healthy children.

Increased pulsatility of the ductus venosus blood velocity in the first trimester is associated with the delivery of small for gestational age or low birth weight infants.

AIM: To determine the relationship between ultrasound findings during the first trimester and obstetrical outcomes. METHODS: A retrospective cohort study was carried out on 516 women who underwent ultrasound examination between 12 and 14 gestational weeks. RESULTS: The reduced crown-rump length, biparietal diameter, femur length (Z-score < -1 and -1.5) and increased umbilical artery pulsatility index (>90th and 95th percentile) were not associated with poor obstetrical outcomes. A ductus venosus pulsatility index greater than the 90th percentile was associated with aneuploidy, small for gestational age and low birth weight infants. CONCLUSION: Increased pulsatility in the ductus venosus is associated with increased risk for chromosomal abnormality in early pregnancy. Here we show that increased pulsatility is also linked to fetal growth restriction.