STUDY OF ADNEXAL MASS IN REPRODUCTIVE AGE GROUP WOMEN AND THEIR OUTCOME

BACKGROUND: Adnexal masses is a significant condition commonly seen in women’sreproductive age. Most common masses arise from ovaries due to their complexembryologic & histologic origin. For diagnosis, ultrasonography is the gold standard.Laproscopy is the gold standard surgical intervention.METHODS: This study was a prospective study that was conducted at a tertiary carehospital in the obstetrics and gynecology department from October 2021 to December2021.RESULTS: In this study, No. 31% of the patients were between the ages of 26 and 35.Of the patients, 12.90% came from the upper socioeconomic class, 72.58% from themiddle, and 14.51% from the lower socioeconomic class. The most common complaintwas abdominal pain (41.93%) followed by menstrual irregularities (25.80%). 46.77% ofpatients were managed medically. In 32.25% of patients, laparoscopy was performed andin 20.96% of patients, laparotomy was performed.CONCLUSION: Adnexal masses are a very common gynecological problem, Presentwith abdominal pain / other symptoms /an incidental finding on ultrasonography done forother purposes. So, the basic approach should be early diagnosis and appropriate medicalor surgical treatment, to minimize morbidity and avoid mortality.

AN ANALYTICAL STUDY OF ABNORMAL UTERINE BLEEDING IN WOMEN OF PERIMENOPAUSAL AGE GROUP

BACKGROUND: Abnormal uterine bleeding complaints constitute about one-third ofpatients attending the Obstetrics and Gynaecology OPD. To standardize nomenclature ofAUB, a new system known by the acronym PALM-COEIN, was introduced in 2011 byFIGO.AIMS AND OBJECTIVES:To study the various abnormal patterns of bleeding presenting in perimenopausal agegroup.To study the etiology, predisposing and associated factors of AUB.To study the various treatment options available for AUB.METHODS: This study was carried in department of obstetrics and gynaecology amongperimenopausal women attending out patient department. The clinical presentation,ultrasonographic findings associated medical disorders, routes of hysterectomy werecorelated.RESULTS: Menorrhagia is the predominant symptom of 109 patients. 101 were associatedwith complain of heavy menstrual bleeding followed by dysmenorrhea. Adenomyosis wasthe most common abnormality found on TVS followed by Endometrial Hyperplasia,Fibroid and polyp. Treatment was initiated in form of conservative medical therapyfollowed by, combination therapy of hormonal drugs-Progesterone and COC and nonhormonal drugs like tranexamic acid + mefenamic acid were used to control bleeding.Hysterectomy was served as a final measure for all patients who didn’t respond toconservative management.CONCLUSION: AUB is a common problem in peri-menopausal age group and itsaccounts for one third of patients visiting Gynecological OPD. It significantly affects thequality of life in general population.

PLACENTAL CHORIOANGIOMA

Introduction : Placental Neoplasms are classified in to two categories based on their origin: Trophoblastic and nontrophoblastic. Non trophoblastic tumors are common and benign ones include chorioangioma andteratoma. Chorioangioma of placenta is the commonest benign tumor of the placenta. It consists of abenign angioma arising from the chorionic tissue. It has been found to be associated with manyserious complications such as nonimmune hydrops, congenital abnormalities, hemolytic anemia,polyhydramnios, IUGR, and IUFD.Methods:A 21 years old pregnant female 2nd gravida with 32 weeks of gestation presented to Ob/Gydepartment at L.G. Hospital with complaints of abdominal distension for 2 weeks associated withlower abdominal pain for 2 days. She had a history of one full term normal delivery withoutsignificant peripartum events. General examination was unremarkable. P/A was grossly enlarged withFundal height more than gestational age, fetal heart rate was 144 /min. Per vaginal examinationrevealed 2 cm dilated and early effaced cervix with intact membrane. USG revealed a single live fetuswith 32 weeks of gestation and without structural malformations and hydrops AFI of 42 cmhyperechoic mass of 8.5 *6.5cm on placental surface, near cord insertion with hypervascularity,separate from placental tissue suggestive of placental chorioangioma. Estimated fetal weight was1.6kg. After a course of dexamethasone, therapeutic amniocentesis was done; She developed grosspolyhydramnios after 4 days of amniocentesis followed by spontaneous preterm normal labor anddelivered 1.7kg live baby without peripartum complications. Histopathological analysis of the massrevealed proliferation of capillary sized vascular channels with endothelial cells, hemorrhagic andfocal area of calcifications. The neonate was admitted to NICU and was discharged after a weekwithout complications.Conclusion :This case illustrates the prompt and accurate diagnosis of placental chorioangioma canhelp apply timely interventions improving patient outcome.