ABSTRACT
Peritoneo-cutaneous fistula is usually a rare but known entity. Such a case has not been reported after cesarean sections. A 26-year female presented to our clinic in May 2019 with persistent sero-purulent discharge from sinus over abdominal skin. The patient had previously undergone a cesarean section in April 2018 for premature rupture of membranes and non-progress of labour. The surgery and puerperal period were uneventful. The patient presented with document high-grade fever in June 2018. In August 2018, a localized painful swelling was noted by the patient herself over the abdomen, contrast-enhanced computed tomography, which suggested 6.3×3.9×3 cm collection in the right adnexal region and a fistulous tract communicating with abdominal skin. For the same she underwent surgery, wide local excision of the fistulous tract around elliptical skin incision was done. The development of delayed peritoneo-cutaneous fistula has been seen as a complication of difficult cholecystectomy.
ABSTRACT
Background: Preeclampsia is a multisystem disorder of unknown aetiology and recently its link with placental laterality has been explored. The objective of this study was to find the association of placental laterality with maternal and fetal outcomes in pregnancy. Study also determined the predictive ability of placenta laterality for the development of hypertension in pregnancy.Methods: A prospective observational cohort study was conducted on 200 pregnant women. Routine investigations and doppler analysis were done. Placenta position was categorized into central and lateral. Maternal and fetal outcomes were recorded. The data was entered in MS excel spreadsheet and analysis was done using statistical package for social sciences (SPSS) version 21.0. A p value of < 0.05 was considered statistically significant.Results: Study found no significant association of placental laterality with hypertension in pregnancy. Various fetal complications, birth weight, Apgar scores and NICU admission were comparable among women with central or lateral placenta (p > 0.05). Even the maternal outcomes like mode of delivery, onset of labor, indication of labor induction and caesarean deliveries were comparable among women with central or lateral placenta (p > 0.05). On applying univariate logistic regression analysis, previous history of hypertension in pregnancy was a significant risk factor for development of preeclampsia with odds ratio of 168.43 (p < 0.05).Conclusions: It can be concluded that the maternal and fetal outcomes are independent of the placenta laterality. The doppler characteristics and placenta laterality did not show any increased risk for hypertension in pregnancy. However future studies are recommended with large sample size including more women with diagnosed hypertension in the pregnancy so that a better association can be derived with placenta laterality and doppler characteristics.