A case report of caesarean myomectomy in a term pregnant woman with fibroid complicating pregnancy: in a tertiary care centre

Uterine leiomyomas are the benign tumors arising from the muscle cells of the uterus. These are the most common tumors observed in reproductive age group and is seen in around 2% pregnant women. The effect of fibroids on the pregnancy varies according to the number, size and their location. Most of the patients are asymptomatic. Recent literature suggests myomectomy during pregnancy and caesarean section is safe in well selected cases with experienced obstetrician in a tertiary care center.

Pregnancy with Gilbert syndrome

A rare case of Gilbert syndrome during pregnancy was reported at Narayana Medical College and Hospital's obstetrics department. Due to the fact that it was an extremely rare case with a typical presentation, it was properly studied and analysed to provide a thorough case report. A 36-week-pregnant primigravida who had been having nausea, vomiting, stomach pain, myalgia, and a yellowish discoloration of both the skin and sclera for the past five days presented to Narayana Medical College and Hospital. She consistently suffered having similar symptoms at 14 and 24 weeks. She had icterus, signs of dehydration, a uterus that corresponds to period of gestation, and a good fetal heart rate. Examination revealed that all of the obtained investigations were normal, with the exception of mild unconjugated hyperbilirubinemia and hypoglycemia. After the dehydration and jaundice were treated, the patient's symptoms improved, and she was discharged from the hospital after a week. Later she underwent an emergency caesarean section due to fetal distress after being admitted during pregnancy at term, and she gave birth to a 3 kg female baby. Mother and baby both were fine postoperatively. Due to its rarity, this case was documented. Almost all of the patients had decreased uridine diphosphate glucuronosyl transferase activity (UDPGT).

Prenatal diagnosis of binders phenotype: a cross road to decision making

Binder’s syndrome is an uncommon congenital condition which develops in the first trimester of pregnancy and has characteristic effects on the facial features. Those effects are: arhinoid face, intermaxillary hypoplasia (associated with malocclusion), abnormal position of the nasal bones, nasal mucosa atrophy, anterior nasal spine agenesis and (in most cases) a lack of frontal sinuses. Other deformities, as well as mental retardation, are also possible. Due to the rarity of the disease, there are no treatment trials for these patients. Treatments reported in the medical literature are part of single case reports or small case series of patients. Here is a case report of a 23-year-old who presented to OPD at 26 weeks with features of binders’ phenotype. This woman delivered an infant of 2.7 kg without other abnormalities and no respiratory distress postnatally. Sonographic evaluation during pregnancy depicts proper differential diagnosis and therapeutic strategy. Multidisciplinary approach is mandatory in order to establish meticulous treatment. Further studies must be conducted, achieving this ultimate scope. Even so, the parents should be counselled that Binder syndrome is a tentative diagnosis prenatally, and that not all genetic syndromes can be prenatally excluded.