Doppler ultrasound study of umbilical artery and middle cerebral arteries in pregnancies complicated by pregnancy induced hypertension [PIH] and/or intrauterine growth restriction [IUGR]

To evaluate the role of Umbilical artery's and Middle Cerebral Artery's Doppler indices as predictors of abnormal perinatal outcome. This study was conducted in Department of Radiology, GMC Hospital, Ajman. Ongoing Study was conducted for a period of 6 Months and included 15 subjects till now. In our method we have shown that among Middle Cerebral Artery MCA PI and Umbilical Artery UA PI pulsatility index [PI], "UAPI has the highest sensitivity and specificity. Of all the indices cerebroplacental Ratio [MCA/UA PI ratio] has more sensitivity and accuracy than others. In conclusion among Umbilical Artery UA and Middle Cerebral Artery MCA PI, UA PI has the peak Sensitivity. Of all the indices Cerebro Placental Ratio has the Highest Diagnostic accuracy. Cautious interpretation of these results in compromised pregnancies can help the clinician to intervene at the right time and thus reduce perinatal mortality and morbidity

Pregnancy at an unusual location: a case report with review of literature

Implantation of the embryo at the site of a previous Caesarean scar is the rarest form of ectopic pregnancy, with a high risk of maternal complications. The incidence of CSP [caesarean scar Pregnancy] is estimated in a recent series as 1:2226 of all pregnancies. A delay in establishing a diagnosis and in starting treatment can result in uterine rupture, massive hemorrhage and serious maternal morbidity, and may require hysterectomy. Several options are available to treat CSP if diagnosed early, although there are no evidence-based guidelines recommended due to its rarity. The management should be tailored to the individual situations. Little is known about the future pregnancies, outcomes and recurrences after fertility-preserving treatments following CSP. We report a case of suspected CSP in a 28 year old Gravida 2, Para one, who was referred to us for the management of incomplete miscarriage. Her previous delivery was six years back and was by Cesarean section. Ultrasound examination revealed that the patient had a large anterior lower uterine segment vascular mass of 9.3x8.2x9cms, suspected to be a persistent trophoblastic tissue invading the anterior uterine wall, though a degenerating fibroid could not be ruled out. The patient underwent dilatation and curettage as she had been bleeding for more than a month and still 3HCG being positive. The procedure was also used to establish a histopathological diagnosis. A follow up MRI and Ultrasound revealed a heterogenous mass. With a strong clinical suspicion based on history and early ultrasound reports, the diagnosis of an anterior uterine wall mass probably due to penetrating trophoblastic tissue on previous caesarean scar was made. The patient has been referred for either uterine artery embolisation or a laparoscopic removal in order to preserve her fertility

large ovarian mucinous cystadenoma in pregnancy: a case report

We report a case of large rare ovarian mucinous cystadenoma complicating pregnancy. Mucinous cystadenomas tend to be hormonally responsive during pregnancy and reach huge sizes. A 31-year-old woman gravida one, para zero, was found to have a right sided ovarian cyst at her first scan on seven weeks gestation measuring 12.1 x 7.8 cm. Serial scans throughout pregnancy showed an increase in the size of the cyst. The last scan done prior to elective cesarean showed a large complicated right ovarian cyst with multiple septation measuring 20.5x13.8x16cm extending to lower border of liver. Emergency cesarean section was undertaken at 38 weeks gestation due to fetal distress. After delivery of the baby, right salpingo- oophorectomy was performed. Histopathologically, a multi loculated benign mucinous cystadenoma was found. This case is fifth reported case of large overiancystadenoma complicating pregnancy in the literature. All ovarian cysts during pregnancy should be followed up by ultrasonography due to the possibility of adverse effects of the cysts on pregnancy

Pregnancy at an unusual location: a case report with review of literature

Implantation of the embryo at the site of a previous Caesarean scar is the rarest form of ectopic pregnancy, with a high risk of maternal complications. The incidence of CSP [caesarean scar pregnancy] is estimated in a recent series as 1:2226 of all pregnancies

A delay in establishing a diagnosis and in starting treatment can result in uterine rupture, massive hemorrhage and serious maternal morbidity, and may require hysterectomy. Several options are available to treat CSP if diagnosed early, although there are no evidence-based guidelines recommended due to its rarity. The management should be tailored to the individual situations. Little is known about the future pregnancies, outcomes and recurrences after fertility-preserving treatments following CSP

We report a case of suspected CSP in a 28 year old Gravida 2, Para one, who was referred to us for the management of incomplete miscarriage. Her previous delivery was six years back and was by Cesarean section

Ultrasound examination revealed that the patient had a large anterior lower uterine segment vascular mass of 9.3x8.2x9cms, suspected to be a persistent trophoblastic tissue invading the anterior uterine wall, though a degenerating fibroid could not be ruled out

The patient underwent dilatation and curettage as she had been bleeding for more than a month and still [3HCG being positive. The procedure was also used to establish a histopathological diagnosis

A follow up MRI and Ultrasound revealed a heterogenous mass. With a strong clinical suspicion based on history and early ultrasound reports, the diagnosis of an anterior uterine wall mass probably due to penetrating trophoblastic tissue on previous caesarean scar was made. The patient has been referred for either uterine artery embolisation or a laparoscopic removal in order to preserve her fertility