ABSTRACT
Primary pelvic hydatid cyst disease is a zoonotic parasitic disease most frequently caused by Echinococcus granulosus or Echinococcus multilocularis. Primary pelvic hydatid cyst is a rare entity. A 39-year-old, para 3 living 3 presented to casualty with acute pain abdomen and a suprapubic mass. Patient gave history of acute lower abdominal pain since 4 days associated with vomiting. On examination, a palpable mass around 18 weeks size, firm to hard in consistency with ill-defined margins and restricted mobility and suprapubic tenderness. Lower limit could not be reached, extending from right iliac fossa to midline. Per vaginum findings suggestive of mass deviated to right side with fullness in right fornix. No cervical motion tenderness. The pre-operative tumor marker levels were as follows: CA125=12.44 U/mL (normal=0-35), CEA=0.09 ng/mL (normal=0-2.5). CA19.9=16.79 U/mL (normal=1.2-30). Erythrocyte sedimentation rate (ESR) was found to be 82 mm in the first hour. Transabdominal ultrasound suggestive of adnexal mass? ovarian with moderate ascites. Urinary bladder seen separately. Contrast enhanced computed topography (CECT) suggestive of complicated right para-ovarian /ovarian cystic mass like cystadenoma. Exploratory laparotomy was done and specimen (uterus, cervix, omental biopsy and peritoneal washings) was sent for Histopathological report. Histopathological examination of the haematoxylin and eosin-stained section revealed ruptured brood capsule releasing daughter cyst. Post-operative period was uneventful. Patient received full course of anti-helminthic treatment.
ABSTRACT
Background: Thyroid disease is one of the commonest endocrine disorder affecting women of reproductive age, and when untreated during pregnancy is associated with an increased risk of complications. The objective of this review was to increase awareness and to provide a review on adverse effect of thyroid dysfunction on maternal and perinatal outcome.Methods: This prospective, observational hospital-based case-control study carried on women coming for antenatal check-up in a Tertiary Care Hospital in INDORE from May 2018-December 2018. 50 known booked antenatal (case) patient with established thyroid disorder, more than 32 week of gestation, and 50-matched euthyroid patients (control) were taken.Results: Women suffering from overt and subclinical hypothyroidism and hyperthyroidism are nulliparous in 72% cases as compared to 32% in euthyroid patient. Increased maternal age was associated with higher incidence of thyroid dysfunction. Normal vaginal delivery by spontaneous labour seen in 56% of euthyroid, while it is reduced with thyroid dysfunction. 38% of altered thyroid profile patient undergo induction of labour and 24% cases undergo caesarean section as compared to control (17%). Adverse fetal outcome like intrauterine growth retardation, preterm birth and ICU admission seen increased with thyroid dysfunction as compared to euthyroid patients.Conclusions: Thyroid dysfunction in pregnancy, although has a low incidence, but is associated with adverse maternal and fetal implications. Thus, thyroid screening should be done in antenatal period to improve fetomaternal outcome.