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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.
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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.
RESUMEN
The presence of functioning endometrium outside the uterine cavity is often encountered in gynaecological practice but an extremely rare entity is its extra pelvic variant is seen sometimes around the umbilicus, anterior rectus sheath vesical region, also rarely seen around the kidney’s nasal mucosa, lungs and the pleura. The incidence of this condition is as low as 0.03% to 0.15%. Endometrioma of the anterior rectus sheath is well documented in literature but because of its rarity may pose a diagnostic dilemma. Reporting herewith a case of anterior rectus sheath endometrioma where medical line of treatment failed and surgical excision was required.
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Reversible visual disturbances in patients with eclampsia may be due to either retinal detachment or retinal arteriolar vasospasm or thrombosis of the central retinal arteries or PRES (posterior reversible encephalopathy syndrome). Although retinal arteriolar vasospasm is the most common mechanism of visual disturbance, cortical blindness may occur in 1% to 15% of patients with eclampsia. Reporting herewith a case of reversible cortical blindness in the setting of severe preeclampsia complicated with eclampsia.
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A cesarean scar ectopic pregnancy -CSEP is a fairly uncommon presentation wherein the conceptus is implanted at the exact scar site of the previous cesarean section deep in the myometrium. Given the relatively rare incidence of CSEP establishing a diagnosis of CSEP can be challenging current standards of therapy have been derived from data obtained from a limited number of patient’s management options for CSEP range from medical line of treatment to surgical interventions such as sonography guided injections to laparoscopic excision or laparotomy or combination of these modalities. Herein we report a rare case of triplet pregnancy with one gestation sac implanted at the site of lower segment scar diagnosed on transvaginal ultrasonography along with MRI who was managed successfully with systemic methotrexate.
RESUMEN
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.
RESUMEN
Vulval swellings have always been a case of a difficult and a puzzling situation and more so when they are huge in size. Vulvar swellings are of various types such as Bartholin cyst, sebaceous cyst, cyst of canal of nuck, inguino-labial hernia and vulval varicosities. Most common vulvar cysts are epidermal inclusion cysts. Usual location is beneath the epidermis. An alternative histogenesis is embryonic remnants or occlusion of pilosebaceous ducts of sweat glands. Cutaneous cysts which are lined by ciliated epithelium are very rare, and authors present a rare case of a cyst arising from a left labium majus resembling a hydrocele seen in males with histopathology suggestive of ciliated cyst of the vulva.
RESUMEN
Pregnancy is a normal physiological state with hyperdynamic circulation that is characterised by important physiological changes, many of which take place in the cardiovascular system. Few patients with physiological bradycardia may, in the second trimester, feel symptomatic as their blood pressure drops due to a reduction in systemic vascular resistance however, treatment is rarely required. Pathological bradycardia in pregnant women is rare and usually secondary to either Congenital heart block, Myocarditis, or Severe Hypocalcaemia with an incidence as low as 1:20 000 women. Authors present a rare case of severe bradycardia during peripartum period who required LSCS in view of IUGR with Anhydroamnios. On admission her general condition was good her pulse was 42 beats per mins and BP was 170/100 mm of Hg with 1+ protinuria. A clinical impression of preeclampsia was made. ECG showed sinus bradycardia with no irregularity. 2 DEcho showed no structural lesion in the heart and normal functional capacity so dilated peripartum cardiomyopathy was ruled out. Her serum electrolytes were normal and serum calcium and magnesium was markedly reduced which was corrected. Post operatively on day 4 pulse was mor than 60 and she was transferred out of ICU. The ECG performed on day 6 was normal.