Accessory cavitated uterine mass (ACUM), a rare cause of dysmenorrhoea, has to be diagnosed with essential criteria and is to be treated with appropriate surgery. Hereby, presenting the surgical approach by laparoscopy and vaginal retrieval of the specimen in toto as a perfect tool. We report a rare case study of ACUM, a mullerian anomaly in a 27 years old female with severe dysmenorrhoea with secondary infertility, evaluated and diagnosed as ACUM. Preoperative diagnosis and surgical plane evaluation are made by ultrasound and magnetic resonance imaging. Hysteroscopic examination of the cavity was normal and laparoscopic excision of an ill-defined mass in the anterior and right lateral wall of 3×2 cm followed by retrieval of the specimen through a pouch of Douglas. Myometrial defect sutured. Cut section showed chocolate coloured fluid in the endometrial cavity and the same confirmed by histopathology. This is the first case report doing vaginal retrieval of ACUM in toto.
Background: The use of heparin and aspirin in obstetric care has grown considerably since their introduction into clinical practice. Because of the physiological changes of pregnancy, the usage of heparin and optimal dosage of heparin remains uncertain. Here our institute designed low dose Unfractionated Heparin (5000 IU s/c daily) as thrombo Prophylaxis regimen. To study the outcome of low dose UFH (5000 IU sc /daily) + Low dose aspirin (75 mg oral per day) for thrombo prophylaxis in utero placental insufficiency, in patient with 2 or more abortions.Methods: This retrospective study was conducted in 135 patients with 2 or more abortions as obstetric history. Prophylactic low dose of UFH (5000 IU s/c daily) + LDA 75 mg oral was initiated. The Primary outcome is live birth, and secondary outcomes is Reduced incidence of early onset of gestational hypertension (HT), Intrauterine Growth Retardation (IUGR).Results: Out of 135 women 131 gave live birth, 2 had first trimester abortion and 2 had intrauterine death by 5 to 6 months. PIH was higher in patients with more than 30 years of age.Conclusions: In our Retrospective, data combination of low dose UFH (5000IU s/c) + LDA (75mg oral) is as safe as routine thrombo prophylaxis with good compliance.
Background & Objective: Uterine fibroids (UF) in pregnancy is a condition, where symptomatic or asymptomatic fibroids in the uterine cavity may cause complications in pregnancies. Placental abruption and preterm labor, occurs in late pregnancy, postpartum hemorrhage, caesarean section and retained placenta in perinatal period. This study aimed to reckon whether the surgical Caesarean myomectomy is still a gold standard in myoma removal in pregnant women.
Materials & Methods:This study was retrospectively conducted in pregnant women deliveries with uterine fibroids who underwent Myomectomy with lower segment caesarean section (LSCS). The caesarean myomectomy cases were compared with LSCS alone controls in 1:2 ratio. The primary outcome is to minimize blood loss and need for blood transfusion. The secondary outcome is the length of surgery duration and hospital stay.
Results:The outcome of case and control compared was 43 caesarean myomectomy with LSCS as case group and 86 LSCS Alone as control group. The incidence of hemorrhage in case group was 10 out of 43 while control was 2 out of 86 (2.32%) with P-value of 0.0017. The secondary outcome was the length of surgery duration and hospital stay which were found statistically significant between the case and control groups, with P-value = 0.0001 and 0.0072, respectively.
Conclusion:Caesarean Myomectomy can be the effective surgical option to enucleate uterine myoma, and preserve uterus and jettison from eventful or symptomatic uterine fibroids. To have the chances for prevention of immediate or interval -myomectomy / hysterectomy and control of post-partum menstrual over bleeding.
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