No abstract
The incidences of twin gestation and higher order multi-fetal pregnancies are on increasing trend. There are increased use of ovulation induction drugs and assisted reproductive technology in this era owing to higher incidences of infertility and better diagnostics and treatment modalities. And with increased use of these methods, comes increased incidence of complications. Incidences of complications are more in monozygotic pregnancies than in dizygotic twin. Acardiac twin is a rare, severe congenital malformation seen in monozygotic twin gestation, which is incompatible with life. Acardiac twin, also known as TRAP (Twin Reversed Arterial Perfusion Sequence); results from abnormal placental vasculature.Early diagnosis of acardiac twin by ultrasonography and colordoppler is essential for timely management and preventing complications like preterm delivery, cardiac failure and intrauterine fetal death of ‘ pump’co-twin. Here we are reporting a case of an antenatally diagnosed mono-chorionic twin pregnancy with acardiac twin, which was managed conservatively. Proper monitoring and timely decision for terminationresulted in preterm delivery of a live, normal twin along with an acardiac co-twin.
Background: Women on vaginal pessary required regular follow-up and good pessary care to avoid complications such as infection, ulceration and incarceration and rare complication like recto-vaginal or vesico-vaginal fistula. We present a case of a neglected vaginal ring pessary which got entrapped or embedded in a band of vaginal tissue. Case Report: A 53 year-old post-menopausal woman presented with bleeding per vaginum. She had history of insertion of a silicone ring-shaped vaginal pessary for the management of uterine prolapse one year back. The patient neglected the pessary, did not turn for follow-up. Pessary had been incarcerated in the vaginal wall; which was impossible to remove. She had excision of band of vaginal tissue and removal of the pessary under general anaesthesia. Conclusion: Women on vaginal pessary need regular follow-up to avoid complications such as infection, ulceration and incarceration.
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