Fetal growth restriction associated with continued maternal sirolimus therapy in pregnancy has not been reported. We hereby present a case of maternal sirolimus therapy resulting in fetal growth restriction and propose a multi-hit model. This hypothetic model is based on inhibition of mTOR signaling pathway and epigenetic modulation. This case report adds to the paucity of literature on continued monotherapeutic maternal sirolimus in pregnancy and its adverse fetal effects.

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Subarachnoid hemorrhage (SAH) can be an initial presentation of cerebral venous thrombosis. Eclampsia and postpartum onset of SAH should prompt physicians to identify possible causes and institute prompt management to avert irreversible cerebrovascular sequelae.

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