A case report on caesarean myomectomy

Routine myomectomy at the time of caesarean section has been condemned in the past due to fear of uncontrolled haemorrhage and peripartum hysterectomy. It is still a topic of debate worldwide. However, in recent years, many case studies of caesarean myomectomy have been published validating its safety without any significant complications like excessive blood loss. We describe the case of a 23-year-old nulliparous women at 38 weeks of pregnancy with history of previous abortion. Her ultrasound was suggestive of singleton live intrauterine pregnancy with multiple intramurals and subserosal uterine fibroids seen in fundus, body region, posterior and anterior myometrium with largest fibroid of size 9×6.1 cm. The patient was taken up for elective caesarean section along with caesarean myomectomy. Live baby was delivered and successful myomectomy was done. Prophylactically oxytocin drip was given and intra myometrial carboprost was given to avoid blood loss. Patient was discharged on post-operative day 12 without any complications. Routine myomectomy at the time of caesarean section is not a standard procedure. However, it may be considered a safe option in carefully selected cases in the hands of an experienced obstetrician.

Observational study of vaginal culture in symptomatic and asymptomatic non pregnant female patient in tertiary care hospital

Background: Vaginal miroflora plays an important role in maintaining healthy microenvironment. Lactobacilli are the dominant flora responsible for this. Any disturbance in balance of normal and abnormal flora leads to different types of vaginal infections like, vulvo-vaginal candidiasis, and bacterial vaginosis. Most common organisms causing vaginitis is Gardnerella vaginalis which causes bacterial vaginosis. Other organisms responsible for infections are, candida, trichomonas, and viruses. Abnormal growth of pathogenic bacteria during pregnancy can lead to various adverse pregnancy outcomes.Methods: This is an observational study conducted in a tertiary care hospital over a period of 6 months (January 2023 to June 2023). Overall, out of 135 women, sample of 120 women were taken and treated accordingly.Results: Among 120 women, 52 (43.3%) women had no growth on culture, while 20 patients (16.6%) showed growth of Klebsiella and 20 (16.6%) patient shows Candida and rest shows growth of other pathogen.Conclusions: In our study, half of the women were found to be with positive culture report, who shown improvement after treatment.