On cardiovascular system examination, the apex beat was in the fourth intercostal space lateral to the mid- clavicular line, S1 was variable and S2 was normal. Per abdomen examination revealed a single live fetus with breech presentation corresponding to 28 weeks of ges- tation with a fetal heart rate of 144 b.p.m. All her blood investigations were unremarkable. All investigations to rule out connective tissue disorder, sarcoidosis and chronic inflammatory disease were negative.