Mature cystic teratoma mimicking ectopic pregnancy: a case report

We present a case of mature cystic teratoma resembling ectopic pregnancy in a patient with positive serum beta-hCG and an adnexal mass. A 30-year-old woman who was experiencing pelvic pain and vaginal bleeding was sent to the emergency room. An ultrasound revealed a complex right adnexal mass measuring 63� mm and the absence of an intrauterine gestational sac. Based on these findings, ectopic pregnancy was suspected; nevertheless, a subsequent magnetic resonance imaging (MRI) was planned, which suggested mature cystic teratoma. On a laparoscopy, later findings were verified. Cyst removal was the patient's treatment. Despite the possibility of an ectopic pregnancy being indicated by the existence of an adnexal mass without an intrauterine gestational sac and a positive beta-hCG level, a mature cystic teratoma should be considered as a differential diagnosis.

Comparative study of endometrial thickness with transabdominal ultrasonography and pelvis in perimenopausal women presenting with abnormal uterine bleeding and correlation with its histopathological findings

Background: Heavy menstrual bleeding is the most common presenting menstrual complaint in women of perimenopausal age group. Diagnostics tests to investigate the causes of abnormal bleeding are transabdominal ultrasonography (TAS), TVS, endometrial biopsy and uterine curettage which is invasive procedure performed under anesthesia. The objectives of this study were to correlate the transabdominal ultrasonography results with the histopathological findings to discriminate normal from pathological endometrium.Methods: Comparative study including 100 perimenopausal women with abnormal uterine bleeding. Endometrial thickness was measured by TAS and then D and C was performed for all the patients.Results: Out of 100 women, (86) had normal and (14) had an abnormal endometrium. 43 were of 41-45 years and 65 patients presented with complaint of heavy menstrual bleeding. Fibroid uterus (24%) was the commonest uterine pathology detected on TAS. 53 of patients had endometrial thickness in the range 10-11.9 mm. Most common finding on HPE was secretory endometrium (44). Endometrial carcinoma was found in 1. Endometrial thickness <12mm was associated with least abnormal endometrial pathology.Conclusions: Irrespective of endometrial thickness all perimenopausal women with HMB should be subjected to TAS followed by D and C which helps in early detection and missing out of endometrial carcinoma.

To Evaluate Role of Transvaginal Sonography over Transabdominal Sonography in Delineating Adnexal Masses

To compare and find diagnostic accuracy of Transvaginal sonography (TVS) over Transabdominalsonography (TAS) in evaluation of adnexal lesions. A cross sectional comparative study of 50 patientsincluding both pre and postmenopausal women who were clinically suspected to have adnexal masswere scanned on Logiq GE C5 Premium ultrasonography unit. TAS was performed with 3.5MHzelectronic macro convex probe followed by TVS with 6.5 MHz end firing electronic TVS probe. TVSwas found to be superior in diagnosing adnexal lesions. In comparison with TAS, TVS diagnosedbenign cystic teratomas (100% versus 40%), endometriomas (90% versus 57.1%), haemorrhagic ovarian cysts (85.7% versus 50%, hydrosalpinx (75% versus 25%), pyosalpinx/tubo-ovarian mass (75%versus 75%), and ectopic pregnancy (100% versus 77.7%). In our study ovarian cancers were betterdetected by TAS due to their large size. TVS was found to be superior in diagnosing adnexal masses ascompared to TAS with more accurate delineation of internal architectural features as wall thicknessand complexity, nodules, septae, papillary projections, internal echoes thereby narrowing the differentials.

Evaluation of Lower Uterine Segment in Women with Previous Cesarean Section by Transabdominal Ultrasonography & its Relation to Feto-Maternal Outcome.

The present study was conducted to assess the lower uterine segment with transabdominal sonography (TAS) in women with a previous cesarean section at 36-38 weeks gestation and to study the relationship between various LUS measurements and feto-maternal outcomes. Out of 110 patients enrolled, 10 (9%) with LUS thickness <2 mm were considered as poor healing group and were taken for elective LSCS. Remaining 100 were divided into two groups, 2-3.5 mm group and >3.5 mm group; 92% patients with LUS thickness >3.5 mm and 14% with LUS thickness between 2-3.5 mm delivered vaginally. The fetomaternal outcomes among patients with LUS thickness >3.5 mm were observed to be significant in the form of lower occurrence of puerperal pyrexia (4%), atonic PPH (4%), blood transfusion requirement (2%), less NICU admission (2%), less number of newborns with Apgar score <7 (2%), and with no cases of stillbirth, uterine rupture or uterine dehiscence when compared with LUS thickness 2-3.5 mm. Thus, patients with LUS thickness >3.5 mm had high rate of vaginal deliveries with favourable feto-maternal outcome, resulting in less maternal and perinatal morbidity and mortality. Thus, patients with ultrasonographic LUS thickness >3.5 mm at 36-38 weeks can be selected safely for vaginal birth after cesarean with favourable fetomaternal outcome.

Sonographic Evaluation of Cervical Length Changes during Normal Pregnancy

This study was aimed to establish reference values of cervical length in normal pregnancy. We studied a cross-sectional sample of 144 pregnant women by transabdominal sonography. The inclusion criteria were sonographic confirmation of gestational age; the absence of any risk factors for preterm birth; and uncomplicated pregnancy. Cervical length was measured in a straight line. Height; age and weight of patients were also obtained. There was a relationship between gestational age and cervical length; which could be described with a linear regression (R = 0.44; P0.05). Our study shows an increase in cervical length with gestational age. Reference ranges constructed for the whole gestational period could be more clinically applicable and useful than a single cut off value for more efficient prevention and management of preterm birth