The anticoagulation of choice for mechanical heart valves is the oral anticoagulant warfarin. Warfarin is associated with increased risk of miscarriage, intrauterine fetal deaths and warfarin embryopathy. This longitudical cross-over study of 5 women observed all 5 having livebirths of healthy infants after heparin-managed pregnancies. Their earlier 8 pregnancies had all resulted in perinatal losses or miscarriages when on regimes based on warfarin.

Intestinal pseudo-obstruction (IpsO) is defined as presenceof clinical features of intestinal obstruction withoutidentifiable mechanical obstructive lesion. IpsO is anuncommon gastrointestinal manifestation of systemic lupuserythematosus (SLE) and is largely under-recognised. Thereare only over 30 published cases in English literature onSLE-related IpsO. Herein, we report two cases of SLE-relatedIpsO to illustrate the importance of early recognition toavoid unnecessary surgical intervention, as SLE-relatedIpsO responds well to systemic high dose corticosteroids.These two cases also demonstrate the apparent associationof IpsO with uretero-hydronephrosis, suggesting that thepossible mechanism could be smooth muscle dysmotility