ABSTRACT
Sirenomelia is an extremely uncommon congenital deformity in which neonate has fused lower limbs associated with various visceral malformations including urogenital and gastrointestinal tract, pulmonary hypoplasia, and potter's facies. The prevalence is 0.8 to 1 per 100,000 newborns. About 300 cases were recorded till date. We describe a case of 31-year G4P1L1A2 with previous lower segment caesarean section with gestational age of 22 weeks 5 days with anomaly scan suggestive of single live intrauterine pregnancy of 21 weeks 5 days with bilateral renal agenesis with placenta previa and no demonstrable amniotic fluid pocket seen. Her pregnancy was uneventful without any medical disorder, drug history, and no congenital anomaly in the family. Termination of pregnancy done by emergency hysterotomy and delivered anomalous foetus with fused lower limb with absent toes, low set ears, absent left ear ostium, imperforate anus, and absent external genitalia. Sirenomelia is fatal congenital anomaly with unclear etiology. Early antenatal diagnosis and termination of pregnancy is the treatment.
ABSTRACT
Background Pre-eclampsia (PE) is a disorder characterized by hypertension that may occur in a pregnant woman who was normotensive earlier. One of the major factors responsible consists of the inflammatory system being activated with cytokines and chemokines. The normal range of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) varies from 1 to 3 and 90 to 210, respectively. Therefore, this study was conducted to compare PE patients with normotensive pregnant women in relation to their NLR as well as PLR. Methodology From January 1, 2021, to December 31, 2022, a case-control study was conducted in the department of obstetrics and gynecology at a tertiary care center. Based on the inclusion and exclusion criteria, a total of 140 antenatal women were included and divided into a case group consisting of 70 women with PE and a control group involving 70 normotensive pregnant women. A blood sample for complete blood count testing was collected to determine NLR and PLR. Results The mean NLR in the case group and control group was 3.52 ± 1.05 and 3.22 ± 0.88, respectively, with statistically significant results. Additionally, the PLR in the case group was 98.08 ± 18.27, and in the control group, it was 85.25 ± 12.36, having a significant difference between both the groups along with a significant difference in the case group among the severe and non-severe PE. Conclusion In antenatal women, NLR and PLR increase with PE along with an increase in NLR and PLR. Additionally, with the availability of a complete blood count, detecting PE ability markers such as the NLR and PLR will be a significant advantage for managing PE to prevent adverse outcomes.
ABSTRACT
An uncommon form of cancer known as a granulosa cell tumor (GCT) arises from ovarian sex cord cells that produce estrogen. The goal of conservative surgery in cancer is to retain organ functions while avoiding severe excision wherever possible. In oncologic gynecological surgery, fertility-sparing surgery (FSS) is a technique that tries to preserve the uterus and ovarian tissue. A 26-year-old woman with nulligravida presented with the main complaints of pain in the right iliac fossa for 10 to 15 days and fullness in the abdomen for one month, along with a change in appetite and noticeable weight loss. The Magnetic Resonance Imaging (MRI) revealed a large, well-defined, multiloculated, solid cystic mass with altered signal intensity. On exploratory laparotomy, an intraoperatively left ovarian cystic mass was seen. The ovarian mass was histopathologically diagnosed as a sex cord tumor of the ovary, with characteristics compatible with adult GCT. Disregarding the follow-up advice on discharge four months later, the patient conceived spontaneously and gave birth to a male child via emergency lower segment cesarean section. In GCTs that have not spread beyond the ovary or in people who have had relapses of the disease, FSS created the groundwork for conception and appeared safe. In the lack of any compelling supporting evidence, the line of care of terminal surgery should always be thoroughly discussed with the patient and advised for women after their families are complete.
