ABSTRACT
The present study was undertaken to find out the role of laparoscopy in evaluation of chronic pelvic pain and to correlate laparoscopic findings with preoperative pelvic findings. Fifty-two women with pelvic pain of more than 6 months duration were included. They were examined clinically and then subjected to Transabdominal sonography and laparoscopy. Of 52 patient's enrolled for study, 51.92% of patients were in the age group of 21-30 years with equal number of cases from rural and urban areas. Abnormal menstrural cycle patterns were seen in 32.70% of patients with menorrhagia contributing 23.07%. 44.24% patients had abnormal pelvic findings on preoperative pelvic examination. Ultrasonography could detect abnormality in 32.70% of patients as compared to Laparoscopy which had abnormal findings in 75%. Most common pelvic pathology was PID in 26.92% followed by adhesions in 12.07% cases which could not be detected clinically and on sonography. Laparoscopy is a more sensitive and superior method for evaluation of chronic pelvic pain as compared to ultrasonography. Laparoscopy can establish a definitive diagnosis, modify and provide treatment without resorting to exploratory laparotomy .
ABSTRACT
A retrospective study was done to estimate prevlance, indications and complications of emergency hysterectomy done for various obstetric indications over two years was carried out. There were 37549 confinements during study period from April 2006 to Aug 2008. Out of this 27213 (72.4%) delivered vaginally and 10336 (27.5%) by Cesarean section. 80 emergency hysterectomies were done, incidence being 2.13 /1000 births. Mean age was 30.5 years. Majority (75%) were from rural areas. Maximum cases were para 2-4. Most common indication for emergency hysterectomy was uterine rupture (40%) followed by atonic PPH (28.75%). Placenta previa (9%). Secondary PPH (6.25%), broad ligament hematoma (6.2%) placenta accreta &increta (2%).fibroid with bleeding (3.7%). Couvelaire uterus (2.1%) and obstructed labour with septicemia (1.2%). Majority of uterine rupture cases were late referrals from rural areas. Out of 32 cases of rupture uterus 20 were with previous LSCS and 12 were multipara. Maternal mortality was 2.5% and the cause of death was related to irreversible shock and DIC. Identification of high risk cases, early referral and procedures like internal illiac artery ligation can reduce the incidence of Emergency Hysterectomy.
ABSTRACT
We present a rare case of invasive mole presenting as pain abdomen and bleeding per vaginum with subsequent hemoperitoneum. Emergency hysterectomy confirmed the presence of molar pregnancy perforating through the fundus.
ABSTRACT
The present study was done to compare the safety and efficacy of misoprostol administered orally and vaginally for medical management of first trimester missed abortion. 100 women with diagnosed missed abortion were taken for this prospective study. Group A comprised of 50 women who were given oral misoprostol and another 50 in-group B were administered vaginal misoprostol. Clinical outcome, time taken for expulsion, number of doses required, side effects and cervical permeability were compared in two groups. Eighty percent in group B and 36% in group A had successful clinical outcome (p=0.000008). 16.6% in group A and 22.5% in group B expelled with a single dose while 50% and 77.5% expelled with complete schedule. Mean duration of expulsion was significantly higher in group A as compared to group B. Nearly ninety percent of women in both groups had good cervical permeability. Side effects were more common in group A. Hence vaginal misoprostol was found to be more effective and safer as compared to oral misoprostol.
ABSTRACT
A rare case of chylothorax complicating sex cord tumour of ovary in a young girl is being reported here. It was successfully managed by using a multipronged strategy consisting of chemotherapy, total parentral nutrition and bleomycin pleurodesis.