ABSTRACT
Background: Pregnancy represents a risk factor in the occurrence of vaginal infection. This study was undertaken to define the persistence of vaginal flora in 280 pregnant women at 14 to 34 weeks' gestation and to evaluate the role of cytology in diagnosis of vaginal infections. It aims to study the maternal and neonatal outcome in pregnancy with vaginal discharge.Methods: High vaginal swab samples and data on epidemiological characteristics were collected from 280 pregnant women between 14-34 weeks with complaints of abnormal vaginal discharge at booking clinic of Indira Gandhi Government Medical College, Nagpur. Vaginal swab was collected and sent to laboratory for further investigation to establish etiological diagnosis. After diagnosis by vaginal swab report, subjects were treated with the specific treatment to individual infection. Subjects were followed up during antenatal period for complications. A birth weight of delivered baby was noted. The data was analysed using software Graph Pad in stat 3.Results: The incidence of abnormal vaginal discharge in pregnancy was 23.9% in one year. The frequency of abnormal discharge was 53% among those aged 20-24 years (97/183), 49.2% in primigravida (65/132). Pain in lower abdomen and back was the most common symptoms i.e. 88.19% in Cases, while 17.36% had vulval pruritus and 14.58% had dysuria.Conclusions: This study recommend that women complaining of vaginal discharge in pregnancy should be evaluated for infections. this study supports CDC-P recommendation as all women who have symptomatic vaginitis, should be treated regardless of pregnancy status.
ABSTRACT
Normal or chronically inflamed fallopian tube can undergo torsion and present as acute abdomen, simulating clinically as ectopic gestation. Torsion of the fallopian tube is less frequent but significant cause of lower abdominal pain in reproductive age women that is difficult to recognize preoperatively. Authors present a rare case of hematosalpinx with torsion at its pedicle with hemoperitonium who presented as 28 years old female with acute abdomen that was successfully treated. In cases presenting with hemoperitoneum diagnosis of ruptured ectopic pregnancy should be made unless proved otherwise during reproductive age. Rarely ruptured ovarian cyst may also be a cause. Unfortunately, hematosalpinx sometimes can undergo torsion due to circulatory imbalance and can present as hemoperitoneum and circulatory collapse due to rupture. There have been no specific symptoms, clinical findings, imaging or laboratory characteristics identified for this condition. Imaging findings are non-specific in the preoperative diagnosis of torsed fallopian tubes. Therefore, most of cases with isolated fallopian tubal torsion had a delayed diagnosis and a subsequent delay of timely intervention that may result in failure to save tubal function. Torsion of tube can lead to hematosalpinx, hemoperitonium and necrosis of tube which necessitates urgent surgical management. This case report describes a twisted hematosalpinx presentation without any predisposing high-risk factors. A tubal torsion should be suspected in females with acute pelvic pain, of any age group. An early diagnosis and treatment are required to prevent complications. This rare case may highlight a new insight into pathogenesis of tubal torsion associated with hematosalpinx.