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Bhuria, V.
- Spontaneous Haemoperitoneum Following Normal Vaginal Delivery
Authors
1 Department of Obstetrics and Gynaecology, PT BDS PGIMS, Rohtak, IN
Source
The Indian Practitioner, Vol 68, No 3 (2015), Pagination: 57-60Abstract
Background: Spontaneous haemoperitoneum during pregnancy resulting from tear or rupture of a uterine or ovarian vessel is a rare yet catastrophic event, which can be a cause of maternal and foetal loss.
Case: A 31 year old woman, Para 6, arrived in our emergency in shock within 12 hours of delivery after an uneventful spontaneous vaginal delivery at a private clinic. Abdominal palpation revealed rigidity and tenderness and uterine fundus could not be appreciated. Ultrasound examination confirmed free fluid in the abdomen and pelvis. Liver, pancreas, gall bladder, spleen and pelvic organs were normal. No obvious source of bleeding was identified. After clinical and sonographic examnation, haemoperitoneum was suspected. Per operative findings were haemoperitoneum equivlent to 500 cc, uterus was intact, a small diverticulum was present on fundus and a small peritoneal tear was present on left posterior surface of uterus with oozing from underlying uterine vessels. Peritoneal tear was stitched along with bilateral uterine artery ligation. Complete haemostasis was achieved.
Result: Her postoperative period was uneventful and patient was discharged on 7th postopertive day.
Conclusion: Haemoperitoneum after normal vaginal delivery is rare but life threatening to mothers. Although very rare, obstetrician should be aware of this cause of acute abdominal pain and hypovolaemic shock in pregnancy. Close observation, prompt diagnosis and proper intervention are the keys to patient survival.
- Comparison of the Maternal and Foetal Outcome in Induction of Labour by Sublingual and Vaginal Misoprostol
Authors
1 Department of Obstetrics and Gynaecology, Pt Bdspgims, Rohtak, IN
2 Department of Obstetrics and Gynaecology, 128/19 Naveen Niketan near Civil Hospital, Pt Bdspgims, Rohtak, IN
3 Department of Obstetrics And Gynaecology, Pt Bdspgims, Rohtak, IN
Source
The Indian Practitioner, Vol 69, No 2 (2016), Pagination: 31-34Abstract
Purpose of the Study: To compare the efficacy and safety of sublingual versus vaginal misoprostol for induction of labour in term pregnancy.Materials and Methods: A total of 100 women admitted for induction of labour at PGIMS Rohtak were randomized to receive 25 μg of sublingual versus vaginal misoprostol for induction of labour.
Results: Majority of women in both groups delivered vaginally (90% in both the groups). The mean number of doses of misoprostol required for induction of labour was similar in sublingual and vaginal misoprostol groups (1.64±0.802 versus 1.96±1.12). The time taken from induction to active phase of labour was 5.72±3.59 versus 7.04±4.55 (hours) in the both the groups respectively. The induction delivery interval was 8.38 (hours) in the sublingual and 7.04 (hours) in the vaginal misoprostol groups. Most of the patients in both the groups did not require oxytocin for augmentation of labour.
Conclusion: The low dose of misoprostol i.e. 25 μg is equally efficacious and safe by both sublingual and vaginal routes.
Keywords
Misoprostol, Vaginal, Sublingual.- Malignant Mixed Mullerian Tumour of Uterus
Authors
1 Department of Gynecology & Obstetrics, PGIMS, Rohtak, IN
2 Medical Gastroenterology, PGIMS, Rohtak, IN
3 Gynecology & Obstetrics, PGIMS, Rohtak, IN
4 Gynecology and Obstetrics, PGIMS, Rohtak, IR
Source
The Indian Practitioner, Vol 69, No 11 (2016), Pagination: 25-29Abstract
Background: Malignant mixed Mullerian tumors (MMMTs) are metaplastic carcinomas including both carcinomatous and sarcomatous elements. Case: A 65-year-old postmenopausal female presented to outpatient department with chief complaints of blood mixed vaginal discharge for the last 10 days. Speculum examination revealed a large, necrotic, foul smelling polyp of approximately 4 x 4 centimeters size seen coming out through the external os. Vaginal examination revealed that the cervix was dilated and taken up and the same polypoid mass was felt coming out through the os. Polypectomy along with endometrial biopsy was done and tissue was sent for histopathological examination which revealed features of malignant mixed mullerian tumor in the polyp and the endometrial biopsy showed necrotic tissue. Result: Patient underwent total abdominal hysterectomy along with bilateral salpingoopherectomy and pelvic lymphnode sampling. On cut section of the uterine corpus, a polypoid growth of size 3 x 2 centimeters was identified which on histopathology confirmed the diagnosis of a homologous uterine malignant mixed mullerian tumor involving more than half the thickness of myometrium. Conclusion: With a highly aggressive nature and limited therapeutic options, MMMTs represent one of the most lethal neoplasms of the female genitourinary tract.Keywords
Polyp, Abnormal Uterine Bleeding.References
- Benedet JL, Miller DM. Tumors of the fallopian tube: Clinical features, staging and management. In: Coppleson M, ed. Gynecologic Oncology, Vol. 2, 2nd ed. Edinburgh, Scotland: Churchill Livingstone, 1992:853.
- McCluggage WG. Uterine carcinosarcomas (malignant mixed Mullerian tumors) are metaplastic carcinomas. Int J Gynecol Cancer 2002; 12:687.
- Mira JL, Fenoglio-Preiser CM, Husseinzadeh N. Malignant mixed Mullerian tumor of the extra ovarian secondary Mullerian system: Report of two cases and review of the English literature. Arch Pathol Lab Med 1995; 119:1044.
- Wheeler JE. Diseases of the fallopian tube. In: Kurman RJ, ed. Blaustein’s Pathology of the Female Genital Tract, 3rd ed. New York, NY: Springer-Verlag, 1987:426.
- Shen DH, Khoo US, Xue WC, Ngan HY, Wang JL, Liu VW, et al. Primary peritoneal malignant mixed Mullerian tumors: A clinicopathologic, immunohistochemical and genetic study. Cancer 2001; 91:1052.
- Nimaroff M, Gal D, Susin M, et al. Extragenital malignant mixed mullerian tumor. Eur J Gynaecol 1993; 14:23.
- Lauchlan SC.Conceptual unity of the Mullerian tumor group. Cancer 1968; 22:601.
- Woodruff D, Solomon D, Sullivant H. Multifocal disease in the upper genital canal.Obstet Gynecol 1985;65:695.
- Sica V, Nola F, Contieri E, et al. Estradiol and progesterone receptors in malignant gastrointestinal tumors. Cancer Res 1984; 44:4670.
- Malhotra V, Nanda S, Chauhan M, Marwah N, Sen R. Heterologous Malignant Mixed Mullerian Tumor of the Uterus and Fallopian Tube: A Case Report. J Gynecol Surg 2012; 28(4): 296-98.
- Cass I, Resnik E, Chambers JT, et al. Combination chemotherapy with etoposide, cisplatin and doxorubicin in mixed Mullerian tumors of the adenexa. Gynaecol Oncol 1996; 61:309.
- Carlson JA, Jr, Ackerman BL, Wheeler JE. Malignant mixed Mullerian tumor of the fallopian tube. Cancer 1993; 71:187.
- Weber AM, Hewett WF, Gajewski WH, et al. Malignant mixed Mu ¨llerian tumors of the fallopian tube. Gynecol Oncol 1993; 50:239.
- Forgotten Lippes Loupe-Accidental Diagnosis for Pain Evaluation
Authors
1 Department of Gynecology & Obstetrics, PGIMS, Rohtak, IN
2 Medical Gastroenterology, PGIMS, Rohtak, IN
3 Gynecology & Obstetrics, PGIMS, Rohtak, IN
4 Gynecology & obstetrics, PGIMS, Rohtak, IN
Source
The Indian Practitioner, Vol 69, No 11 (2016), Pagination: 32-33Abstract
Background: The intrauterine device (IUD) is the most commonly used contraceptive method in the world. Case: We report here a case of 64 year old female who was totally unaware of IUCD insertion done 40 years back until she was evaluated for pain abdomen. Result: Her post-operative period was normal. Conclusion: Ultrasound can guide the location and help in removal of IUCD but hysteroscopy is the gold standard in managing missed IUCD.Keywords
Lippes Loupe, Sonography, Hysteroscopy.References
- Pisal N, Mammo M: Case-series report: management of post-menopausal bleeding in the presence of an intrauterine device. Contraception 2002; 66(5):383–384.
- Peipert J, Zhao Q, Allsworth J, Petrosky E, Madden T, Esienberg D, Secura G:Continuation and satisfaction of reversible contraception. Obstet Gynecol 2011; 117(5):1105–1113.
- The ESHRE Capri Workshop Group: Intrauterine devices and intrauterine systems. Hum Reprod Update 2008; 14(3):197– 208.
- Harrison RF. Adenocarcinoma of the uterine body following use of Intrauterine Contraceptive Device. Irish Journal of Medical Science 1971; 140(9): 407-09.
- Thomsen RJ, Rayl DL. Dr. Lippes and his loop. Four decades in perspective. Jr Reprod Med 1999; 44(10): 833-3.
- Pollock M. Letting uterine device lie. Br Med J 1982; 285: 395–396.
- Ravindra P, Okram S, Vijayalakshmi S. Forgotten Lippes loop. Jr of Dental and Medical Sciences 2013; 8(5): 19-20.
- Sanyal C, Pahari K, Sharma M. Primary carcinoma of fallopian tube after prolonged retention of Lippes loop. Indian Med Assoc 1998; 96(1): 25-26.
- Singal SR, Madan S, Nanda S. Forgotten Lippes Loop associated with Endometrial Carcinoma. Jr of South Asian Fed of Obs & Gyn. 2011; 3: 147-48.Gyn. 2011; 3: 147-48.