Twin pregnancy one sac with missed miscarriage, second with molar pregnancy

A 32 years old lady G4P2A1, presented with gestational amenorrhoea of 13 weeks and complain of vaginal bleeding one week back. Ultrasound examination revealed an irregular gestational sac with no fetal pole and another well circumscribed mixed echogenecity lesion filling the whole of uterine cavity. Features were consistent with molar pregnancy. Suction curettage was done. Histopathology report revealed complete hydatidiform mole and missed miscarriage

Post menopausal bleeding in patient with infantile uterus

A 58 years old female patient married for 40 years, nulliparous, presented in outpatient department with the complaint of postmenopausal bleeding off and on for six months. Her total abdominal hysterectomy and bilateral salpingoopherectomy was performed. Uterus was small in size [infantile]. Histopathology revealed endometrial hyperplasia with atypia

Comparison of mini laparotomy and laparoscopic ovarian drilling in management of polycystic ovarian disease

Objective: To evaluate the intra-operative and post operative morbidity associated with minilap and laparoscopic ovarian drilling in patients with polycystic ovarian disease

Setting and Duration: Gynae Unit I of Jinnah Hospital Lahore and Ghurki Trust Teaching Hospital, Lahore and Surgimed Hospital Lahore from January 1999 to June 2004

Patients and Methods: A total of 76 patients were included in this study. All patients required ovarian drilling. Patients were randomized into 2 groups - one undergoing laparoscopic drilling [36 patients] and the other group had drilling via minilap [40 patients]. The intra operative complications and post operative morbidity were analyzed

Results: 36 patients had ovarian drilling via laparoscopy. Bleeding was seen in 6 [16.6%] patients, in 2 [5.5%] patients laparotomy had to be done to control bleeding; visceral perforation was seen in 2 [5.5%] patients. Of 40 patients undergoing laparotomy, bleeding was seen in 1 [2.5%] patients only. No visceral perforation was seen in this group. Easy approachability was seen in the minilap group. The duration of hospital stay in both groups was 1.5 days

Conclusion: Mini laparotomy as a route for ovarian drilling is a safer option; with no increase in duration of hospital stay and is associated with lower morbidity

Management of ovarian cyst during pregnancy

Objective: To determine the optimum management of ovarian cyst in association with pregnancy

Setting and duration: From January 1999 to December 2003 in Gynae Unit I, Jinnah Hospital Lahore and Ghurki Trust Teaching Hospital, Lahore

Patients and methods: 21 patients were included in this study. All patients presented in early 2nd trimester of pregnancy [14-26 weeks]. Simple ovarian cysts were seen in 20 patients. One patient had a multiseptate cyst and had cystic and solid areas

Results: 2 [9.52%] patients had laparotomy for cyst removal in the puerperium; 4 [19.04%] had cystectomy at the time of LSCS while 71.4% [15 patients] had laparotomy for ovarian cystectomy during pregnancy due to torsion. The histopathology report was follicular cysts in 20 patients [95.23%] while 1 [4.76%] had a germ cell tumour. This patient was given PEB [cisplatin, epirubicin and bleomycin] chemotherapy after 20 weeks of gestation

Conclusion: Ovarian cyst in combination with pregnancy is seen in 0.01% of pregnancies. Management depends upon the presentation and symptoms. Laparotomy done in the 2,d trimester usually does not cause fetal loss. The cysts are usually benign with malignancy seen very rarely