Successful pregnancy following resection of recurrent retroperitoneal liposarcoma

Retroperitoneal liposarcoma is rare in pregnancy. Management of recurrent disease following surgical resection remained a challenge especially when it is associated with pregnancy. A 30-year old primigravida conceived spontaneously four months following a second laparotomy for resection of recurrent RPLS. The primary surgery was performed four years earlier with optimum postoperative course in the absence of need for postoperative adjuvant treatment Histology of the recurrent tumor confirmed a well differentiated liposarcoma. She was monitored closely for any worsening of symptoms and underwent a MRI and an ultrasound at 12 and 22 weeks gestation respectively. The pregnancy continues to be uneventful and she safely delivered vaginally at 41 weeks gestation. Small RPLS during pregnancy do not pose great obstetrics management challenges. Early detection with multidisciplmary team management would anticipate possible complications to ensure both maternal and fetal wellbeing

Short Review Of Fourteen Years Maternal Mortality In Achieving Mdg5 In UKMMC

Worldwide maternal mortality rate had reduced tremendously including Malaysia. At the 2000 Millenium Summit, eight Millenium Development Goals (MDGs) were established with target for the year 2015. Three years remained until the dateline to achieve MDG5, which comprised of two targets and one being reducing the maternal mortality ratio by 75%. This review compared the trend of maternal mortality and its causes in our centre to the national data. The national data had shown a reduction from 44 to 27.6 in 100 000 live births in1991 and 2008 respectively. The subsequent rate had stabilized for the past seven years. In contrast the UKM Medical Centre (UKMMC) data in the past 15 years had not been stable. The target of MDG5 seemed to be achievable by our country but may require longer time as we have yet to find ways to overcome medical care inadequacy in remote areas.

Case Review: Post Partum Vulvo-vaginal Haematomas and Options of Management

Vulvo-vaginal haematomas are not an uncommon obstetric complication. Despite advances in obstetric care, practice and technique, vulvo-vaginal haematomas do occur especially in complicated vaginal deliveries. Various management options are available for vulvo-vaginal haematomas. We describe three cases of vulvo-vaginal haematomas with different severity and presentations which were managed in different manners i.e. local haemostasis control, laparotomy with hysterectomy, and transarterial embolisation. The choice of treatment options would mainly depend on the clinical presentations, availability of expertise as well as facilities. Early identification is crucial.