Life Threatening Vaginal Haemorrhage from Coital Laceration in a Post-Menopausal Woman

Background: Life threatening coital laceration from consensual intercourse in the postmenopausal period is unusual without any predisposing factors(s). The usual site of occurrence is the right side of the posterior fornix. Aim: To report a case of haemorrhagic shock from coital laceration. Design: Case report : A 55-year-old woman who presented as an emergency with haemorrhagic shock following vaginal bleeding from consensual coitus is presented. She was resuscitated with intravenous fluids and blood transfusions. The vaginal laceration of about 5 cm on the right side of the posterior fornix was sutured following examination under anaesthesia. Conclusion: Coital laceration should be considered a differential diagnosis in any postmenopausal vaginal bleeding while prompt recognition and treatment are important to avoid morbidity and even mortality

Ruptured Heterotopic Pregnancy and Subsequent Vaginal Delivery at Term

Background: Heterotopic pregnancy is the co- existence of intrauterine and extrauterine gestation at the same time. The condition is life threatening when the ectopic pregnancy ruptures and it is unrecognized.Objective: To report the first successfully managed case of heterotopic pregnancy in a woman without obvious risk factors in our centre.Result: A multiparous 30 - year old lady who had heterotopic pregnancy with natural conception and salpingectomy for the ruptured ectopic component delivered a live baby at term . Management of the ectopic pregnancy with viable intrauterine pregnancy delivered at termConclusion: Heterotopic pregnancy though rare; is possible in our women without known risk factors. Medical practitioners should have a high index of suspicion when a parous woman presents with lower abdominal pain in the first trimester of pregnancy