A Rare Case Of Term Viable Abdominal Pregnancy With Review Of Literature

Abdominal pregnancies are rare types of ectopic pregnancies with high rates of maternal and perinatal morbidity and mortality. Abdominal pregnancy accounts for up to 1.4% of ectopic pregnancies. We report a case of term live abdominal pregnancy without malformation with implantation of the placenta into the uterus and anterior abdominal wall, discovered during a planned obstetric hysterectomy indicated for placenta accreta. Abdominal pregnancy is a serious and potential life-threatening condition. Diagnosis and management can be difficult especially in developing countries. A high index of suspicion is key for timely diagnosis and intervention to prevent life-threatening complications

A Comparative Analysis of Cryptomenorrhea in Patients with Vaginal Obstruction Vis a Vis Patients with Rudimentary non Communicating Horn of Uterus with Functional Endometrium: A Retrospective Study

Background:To analyse the clinical features, diagnostic challenge and treatment options in patients presenting with pain abdomen and cryptomenorrhea in patients with vaginal obstructive lesions in comparison with those having normal vagina but having non communicating rudimentary horn with functional endometrium. Methods: The clinical details of patients presenting with cryptomenorrhea to our institute was studied. The data collected was from a period of 7 years; from March 2010 to April 2017. The clinical details were collected from cases sheets of the respective cases. Result: A total of 6 cases were studied. Among the 6 patients, all were within the age group of 13-20 years. 3 patients had abnormality in the form of vaginal agenesis, transverse vaginal septum and imperforate hymen. All the 3 presented with amenorrhea and severe cyclical pain. The other 3 patients had rudimentary non communicating horn with functional endometrium and had different clinical presentations. One had severe dysmenorrhoea, one had severe cyclical pain with amenorrhea and the third patient had been operated earlier and presented with severe dysmenorrhoea with an incision site sinus with discharge of menstrual blood abdominally along with vaginal passage of menses. Since reflux of menstrual blood is seen in all cases, endometriotic ovary was found in 2 cases. One had only hematosalpinx . Two patients have been operated earlier for endometriotic cyst but the abnormality in the uterus or vagina was not detected, leading to reoccurrence of symptoms. Conclusion: Cryptomenorrhea or hidden menses due to congenital malformation in the uterus or vagina is a rare condition but can lead to distressing symptoms of dysmenorrhoea in young girls. It can also cause endometriosis due to retrograde menstruation .Improper evaluation can miss the proper diagnosis and patient may be operated only for endometriosis of ovary as a cause for dysmenorrhoea. Not identifying and treating the primary abnormality will lead to recurrence of symptoms and repeat surgeries in patients.