Massive ascites following spontaneous vaginal delivery in a woman with preeclampsia-a diagnostic and management challenges in a low resource country: A case report.

INTRODUCTION AND IMPORTANCE: Hypertensive disorders of pregnancy, including preeclampsia, causes major pregnancy associated morbidity and mortality. Massive ascites is a rare complication in a severe preeclampsia. This case report high lights the importance of obstetrician being aware of such complications of severe preeclampsia, and avoid non-therapeutic interventions such as exploratory laparotomy. CASE PRESENTATION: A 39-year-old woman from remote village of Bhutan with severe preeclampsia had spontaneous vaginal delivery in the ambulance at 34+6 weeks of gestation enroute to a tertiary care hospital. In the postpartum period, she had a massive ascites, and she underwent exploratory laparotomy. DISCUSSION: Ascites in severe preeclampsia is a rare complication. Diagnosis and management of such a rare condition is challenging in a resource constraint setting. In addition, prevalence of tuberculosis and gynecological malignancies in our setting prompts obstetricians to perform an invasive procedure such as exploratory laparotomy in view of excluding these conditions. CONCLUSION: This case report highlights the importance of obstetricians to be aware of the possibility of ascites in preeclampsia which may be managed medically, without the need for surgical interventions.

Tea bag filter paper as a novel protective membrane for micro-solid phase extraction of butachlor in aqueous samples.

An innovative, cost-effective, simple, and environmental friendly tea bag filter paper protected micro-solid phase extraction (µ-SPE) technique was developed for the first time with the aim to miniaturize and minimize the use of organic solvents for the extraction and determination of butachlor in aqueous samples. The µ-SPE device was produced by packing 3.0 mg of an easily synthesized new sorbent, hydroxyl-functionalized polypyrrole (OH-PPY), inside a small tea bag filter paper sachet (1.0 cm × 0.5 cm) that served as a protective envelope. Both the extraction and desorption procedures were facilitated by sonication. Due to the high porosity and the fast water absorption of the tea bag filter paper, the analyte could easily diffuse through and enhance the interaction with the sorbent. Under the optimized conditions for the GC-ECD and the µ-SPE, the limit of detection (S/N ≥ 3) was 2.0 µg L(-1) while the limit of quantitation (S/N ≥ 10) was 10.0 µg L(-1). The recoveries of the butachlor spiked at 0.050, 0.10, and 0.50 µg mL(-1) ranged from 77.9 ± 3.0 to 112.5 ± 2.9%. The proposed method was successfully applied for the determination of butachlor in water samples from paddy cultivation sites. The levels found were from non-detectable to 24.71 ± 0.37 µg L(-1).