Abstract:Transverse vaginal septum is one of the rare mullerian anomaly with recurrent cicatrization of septum being its most common complication. A 29 year old patient with secondary amenorrhea and abdominal mass, was diagnosed as having recurrent cicatrization of transverse vaginal septum. She was operated twice abdominally and many attempts for septum resection with dilatation were carried out vaginally. Resection of the obstructing membrane to lengthen the lower vagina and overlapping vaginal mucosal anastomosis was done.
Noninvasive prenatal testing (NIPT) has revolutionized the screening methods for fetal chromosomal aneuploidies with high utility for aneuploidies for common chromosomes 13,18, 21, X and Y. Trisomy 13 is often associated with major and minor fetal malformations and can be screened by antenatal fetal scan and first- and second-trimester biochemical screening. We describe a case with high risk for trisomy 13 on NIPT, but without any fetal abnormalities on fetal scan. As recommended, follow-up invasive testing of amniotic fluid by chromosomal microarray detected a microduplication on chromosome 13, which has been associated with congenital microcoria. This case demonstrates the high sensitivity and clinical utility of NIPT in detecting rare copy number variations, which can assist families in making informed reproductive decisions. This also emphasizes that all screen positive NIPT cases should be confirmed with an appropriate diagnostic test by an invasive method.
OBJECTIVE:This study was designed to identify various factors affecting women's decision to undergo hysterectomy, to know the reasons for preference of hysterectomy over medical and surgical conservative management and observe occurrence of various uterine pathologies in relation to age. METHODS: A prospective observational study of 600 patients who underwent hysterectomy for various etiologies by different routes at Sola Civil Hospital, Ahmedabad over a period of 1 year (from jan-13 to Dec 13) was carried out. RESULT: percentage of patients undergoing hysterectomy in prolapse and adenomyosis group patients are 100% and 96.29% In DUB 64.39% and the fibroid group 68.10-% patients preferred hysterectomy as a first line of treatment. CONCLUSION: DUB was recognized as the most common indication for hysterectomy amongst reproductive age women whereas prolapse was the commonest indication in women over 50 years of age. A considerable number of patients with PID preferred medical management Patients with DUB and fibroid preferred conservative surgical and medical management before finally opting for hysterectomy but more than 64% patients in both group opted hysterectomy as first-line treatment.. Cost of medical management and affection of quality of life were identified as major reasons for diverting to permanent cure (hysterectomy) in DUB patients. Belief of uterus as a vestigial organ after completion of childbearing was reason for hysterectomy in PID and prolapse patients. KEYWORDS: Hysterectomy, DUB, Prolapse. INTRODUCTION:Hysterectomy is one of the most commonly performed major operations. 55% of pts visiting gynecology OPD has menstrual problems. Among all patients of menstrual problems of various age groups, 10-15% patients undergo hysterectomy. In Indian scenario, uterine prolapse influence significant portion of patients undergoing hysterectomy.Abnormal uterine bleeding (AUB) is a common presenting symptom in the family practice setting. (8) It is an embarrassing problem affecting woman's routine work. AUB includes DUB and other causes like pelvic pathology, medications, systemic disease or pregnancy.DUB is most common cause of AUB but remains diagnosis of exclusion. Incidence of DUB is 10 % in reproductive age women. (1) Medical management of dysfunctional uterine bleeding depends upon whether the patient is in pre, peri or postmenopausal state. Medical treatment may include oral contraceptive pills, cyclic progestins, non-steroidal anti-inflammatory drugs and the levonorgestrel intrauterine contraceptive device. (3) However, as pre-menopausal period is variable, may extend over few months to year, prolonged medical treatment required, cost of treatment and reversibility of symptoms after stoppage of treatment are influencing factors to prefer surgical management (5) .In addition, according to Indian tradition, women cannot involve in holistic activities or worship god during their menstrual phase and hence menorrhagia and metrorrhagia hampers their
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