ABSTRACT
OBJECTIVES: We aimed at evaluating the predictive value of amniotic fluid index ≤5 on perinatal outcome in terms of effect on cardiotocography, mode of delivery, meconium in liquor, birth weight, fetal distress, APGAR score at birth and neonatal admission to ICU. METHODS: This is a prospective study of 308 antenatal women admitted to labor ward of MIMS during February 2014-December 2015 with gestational ages between 34 and 41 weeks. All women enrolled were subjected to history taking, examination, AFI estimation and compared between those with AFI ≤5 from rest. RESULTS: The non-reactive CTG, cesarean section rate due to fetal distress, low birth weight, APGAR score <7 and NICU admission were significantly high among those with oligoamnios than the control group. CONCLUSION: Oligoamnios has a significant correlation with adverse perinatal outcome.
ABSTRACT
PURPOSE: To compare the clinical results of three techniques of hysterectomy- abdominal hysterectomy (AH), non-descent vaginal hysterectomy (NDVH), and laparoscopic-assisted vaginal hysterectomy (LAVH). METHODS: A simple prospective randomized study was performed in a tertiary care centre between June 2011 and Dec 2012, among 150 consecutive women indicated to undergo hysterectomy for benign and mobile uterine conditions. They were randomly assigned 50 each to three routes of hysterectomy; (abdominal, vaginal, and laparoscopic-assisted vaginal). Outcome measures including operating time, blood loss, rate of complications, consumption of analgesics, and length of hospital stay were assessed and compared between groups. RESULTS: As far as duration of operation, mean blood loss, analgesic requirement, length of hospital stay, P value was significant. Incidence of complications is least among VH group. CONCLUSION: Vaginal hysterectomy is the gold standard in the era of minimal access surgery. Some of the contraindications to VH can be overcome by assistance of laparoscope and a potential abdominal hysterectomy can be converted to a vaginal procedure.
ABSTRACT
After performing its role in procreation during the reproductive years, the fallopian tube harbours a malignancy during the postmenopausal years like any other reproductive organ and putting a diagnostic dilemma as to the source of primary focus. A rare case of primary adenocarcinoma of fallopian tube is reported in a 71 years postmenopausal P6L5, presented with pain abdomen for 6 months, loss of appetite and abdominal distension for 4 months and on and off serosanguineous vaginal discharge for 1 month. After clinical and laboratory evaluation it was provisionally diagnosed as a case of adenocarcinoma of ovary. Exploratory laparotomy was carried out and the intra-operative diagnosis was fallopian tube carcinoma with intraperitoneal metastasis--surgical stage III disease. Cytoreductive surgery was performed. Histopathology confirmed the diagnosis. Surgery was followed by chemotherapy with cisplatin and cyclophosphamide regime. Due to advanced stage of the disease and general debility of the patient, although dubulking and chemotherapy course was not perfect but patient improved in her general condition. Now she is leading a symptom-free healthy life after 3 years of treatment; follow-up with CA-125 and USG showing no evidence of secondaries. The disease process is presented in advanced stage early in the course of disease even without involving the muscularis and serosa in contrast to ovarian carcinoma which has to come through the capsule.
