ABSTRACT
Postmenopausal patient presenting with pain and lump in abdomen should be considered as a complication caused by gynaecological malignancy unless proved otherwise pyometra is most common in postmenopausal women but it can affect women of child bearing age as well. Usually it is caused by impairment of natural drainage of the cervix due to malignant diseases of genital tract and consequences of their treatment with radiotherapy. Authors report one such case with cervical intraepithelial neoplasia with uterus markedly enlarged to 26-28 weeks size with Vaginal stenosis in an eighty-year-old postmenopausal patient.
ABSTRACT
Large population-based studies on stroke report that intracerebral haemorrhage is rare in young women however it is a grave and disturbing complication of pregnancy. Preeclampsia is usually clinically silent, but may cause symptoms of neurological dysfunction such as headache, visual disturbances and impairment of consciousness. Eclampsia is in the occurrence of seizures in the context of preeclampsia and is often, but not always, preceded by the above neurological symptoms. Most published data support the view that preeclampsia and eclampsia are important causative factors for pregnancy related ICH. Sparse data is available with respect to the management of such cases. Identification of near miss cases is an important step in reducing mortality. Herein we report a near miss case of eclampsia with intracranial haemorrhage requiring craniotomy.
ABSTRACT
Background: There has been a rising incidence of pregnancy complicated by heart disease in India. The importance of heart disease in pregnancy lies in its high morbidity and mortality in both maternal and fetal outcomes combined with lack of enough established guidelines in its management.Methods: A study was done in department of obstetrics and gynaecology, KEM hospital, Mumbai from January 2016 to April 2017 retro prospectively studying the different manifestations of heart disease in pregnancy and the maternal and fetal outcomes.Results: During the study period, there were 6500 deliveries in the study center and of them 135 presented with heart disease. Of the 135 cases observed, 100 cases came under the inclusion criteria and were included in the study. The incidence of heart disease in pregnancy in the current institute is 2%. In the 100 cases, 55% were seen to have Rheumatic heart disease, 32% with cyanotic and acyanotic congenital heart disease and 13% with other conditions such as peripartum cardiomyopathy and mitral valve prolapse. Maternal outcome shows 44 patients delivered vaginally, 21 by assisted vaginal delivery and 35 required caesarean section. Maternal adverse cardiac events comprised of heart failure seen in 11 cases, ICU admissions required in 14 patients and maternal mortality in one case. Neonatal outcome comprised of 31 preterm births, still births 2, low birth weight seen in 41 and 16 needing NICU admissions.Conclusions: Early diagnosis and prompt management with a multidisciplinary approach is fundamental in managing a case of heart disease in pregnancy.