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Placental polyp is retained placental tissue within the endometrial cavity, which forms a nidus for inflammation and bleeding. Placental polyp is a rare entity with an incidence of less than 0.25% of all pregnancies as reported. Here, we report a case of 23-year-old P2L2 woman with complaints of intermittent vaginal bleeding since her recent normal vaginal delivery, 1.5 months back. A polypoid mass (51×41 mm) with abundant vascularity was detected as retained products of placenta (RPOC) within the endometrial cavity by imaging studies. A combination of polypoidal mass within the endometrial cavity with normal beta human chorionic gonadotropin (hCG) of <2.0 mIU/ml raising the suspicion of retained products of placenta or trophoblastic neoplasms. After yielding an unsatisfactory biopsy containing only fibrin deposition, total hysterectomy was performed due to profuse bleeding during biopsy. The uterus specimen showed slight globular enlargement with presence of a red-coloured polypoid mass within the endometrial cavity with rough outer surface and fragile consistency. The histological specimen of the protruding lesion, from the exaggerated placental implantation site, showed intermediate trophoblastic cells infiltrated into the myometrium, which might lead to the diagnosis of placental polyp. However, since placental polyp and uterine arteriovenous malformation have similar clinical characteristics, it is important to accurately identify and differentiate between them to ensure optimal treatment therapy. Definite diagnosis is ultimately made by histopathological examination. We report here a case that is suggestive of either a placental polyp or uterine arteriovenous malformation and will discuss the differential diagnoses and treatments for both diseases, based on a literature review.
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Background: Because of improving medical and surgical management, most infants born with congenital heart disease (CHD) will reach reproductive age, and women are now presenting for obstetric and congenital cardiac care, many following reparative cardiac surgery or intervention. The maternal and fetal risk of a pregnancy for this population will depend on the anatomic and physiologic classification of the type of CHD. Aim of the study was to determine any complications during pregnancy and after birth in pregnant mother with CHD and to find out any complications of newborn baby, born to a mother with CHD.Methods: The present study was descriptive observational study. This study was conducted for 1 year in department of obstetrics and gynaecology, IPGME and R and SSKMH, Kolkata, sample size 71.Results: In our study there is no maternal death. Most of patients had vaginal delivery under local anesthesia. Thus, concluding early intervention and proper follow up can reduce the morbidity and mortality in CHD mother, vaginal delivery should be preferred in case of CHD in pregnancy. Also, baby born to CHD mother do not suffer from the same disease.Conclusions: We concluded that early intervention and proper antenatal check-up can improve the outcome of the pregnant women with CHD as well as the baby, combined obstetrics and cardiac follow-up can reduced maternal mortality rate. There is no correlation between mother heart diseases with baby.
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Background: The hematological values of the new born is amenable to certain changes under the influence of fetal, maternal, and environmental factors. Aims and Objectives: The aims of this study was to study the effect of maternal factors on hemoglobin content and reticulocyte count in umbilical cord blood of newborns of Sikkim. Materials and Methods: A total of 150 cord blood samples from newborns delivered at CRH Hospital and STNM Govt. Hospital, Gangtok, Sikkim were analyzed. Two ml of cord blood was taken in an ethylene diamine tetra acetic acid tube under aseptic condition and within 6 h: Hemoglobin estimation and Reticulocyte count was done. Results: The mean reticulocyte count was 2.48 ± 0.87% in normal vaginal delivery (NVD) and in C/S was 3.06 ± 0.97%. The mean hemoglobin content was 13.9 ± 2.6 g/dL in NVD and in C/S was 16.1 ± 3.4 g/dL. P < 0.05 for cord hemoglobin and reticulocytes in relation to mode of delivery was found to be highly significant. The mean reticulocyte count was 2.85 ± 1.0% in normal pregnancy and in complication of pregnancy was 2.9 ± 0.70%. The mean hemoglobin content was 15.36 ± 3.31 g/dL in normal pregnancy and in complication of pregnancy was 16.1 ± 3.4 g/dL. The reticulocyte count was found to be statistically significant in relation to complication of pregnancy. The mean mother’s hemoglobin was 11.16 ± 1.27 when cord hemoglobin content was <14 g/dL and was 11.88 ± 1.24 g/dL when cord hemoglobin content was >14 g/dL. There was statistical significance between the cord hemoglobin content and the hemoglobin content of the mother. Conclusion: Maternal anemia leads to lower circulating hemoglobin in new born. Cord blood screening is a useful means for identification of anemia in neonatal period. High reticulocyte count in neonates denotes active erythropoiesis which might help to defer transfusion unless there were other special reasons for proceeding.
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Comparing cord blood levels of total Creatine kinase (CK) and Creatine kinase MB isoenzyme (CK-MB) in newborns delivered by vaginal delivery and cesarean section. Study Design: Descriptive prospective study. Place and Duration of Study: All neonates delivered from September to October 2012 at the obstetric ward of Mousavi hospital. (Zanjan, Iran). Methodology: Total cord blood CK (CK) and MB isoenzyme (CK-MB) was measured immediately after delivery. Rout of delivery and APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) Score were also assessed and all data were analyzed by using SPSS 16.0 software. Results: One hundred and seventy six newborns were recruited (57.4% male and 42.6% female). We found significant association between serum CK-MB level and rout of delivery. There was no significant association between serum levels of total Ck and CK-MB and APGAR score (p˃0.05). Discussion and conclusions: This study showed that newborns who were vaginally delivered had elevated CK-MB levels.
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Objective: To determine the changing of trend in methods of delivery in a university hospital, the correlation among each method of delivery as well as the correlation of the cesarean section rates and the perinatal mortality rates. Methods: The medical records of birth in Siriraj Hospital during 1979-2006 were collected and analyzed. The methods of delivery from these data were grouped and categorizes as following : vaginal delivery, cesarean section, forceps extraction, vacuum extraction, vaginal breech delivery and others. Each method of delivery was studied separately in detail for time and accordingly trend and comparatively to the others to find interaction among them. The changing of trend of perinatal mortality rates were also demonstrated to identify the correlation with the cesarean section rate. Results: There were totally 442,635 births for this study. It was found that the percentage of vaginal delivery was decreased from 82.35 % in 1979 to 58.44 % in 2006 while the cesarean section rates was increased steadily from 7.06% in 1979 to 37.77 % in 2006. The other methods of delivery such as forceps extraction, vacuum extraction and vaginal breech delivery do not play significant roles in this changing trend since they have only small proportions ranging from about 2-5% of all deliveries. In the view of perinatal mortality rate , it continuously declined and has been less than 10% in the last 10 years. Conclusion: Regarding to 28-year review, it is clearly established that methods of delivery are now changing. Cesarean section rate rises steadily with unpromising sign of stabilization and is now far beyond the rate suggested by WHO. It directly effects the downward trend of vaginal delivery and also may be to the other methods of delivery such as vaginal breech delivery, forceps extraction and vacuum extraction, approaching the extinction. This study found no significant correlation between the increasing cesarean rates and the perinatal mortality rates.