Methylenetetrahydrofolate reductase (MTHFR) gene mutations have been implicated as risk factors for neural tube defects (NTDs). The best-characterized MTHFR genetic mutation 677C→T is associated with a 2–4 fold increased risk of NTD if patient is homozygous for this mutation. This risk factor is modulated by folate levels in the body. A second mutation in the MTHFR gene is an A→C transition at position 1298. The 1298A→C mutation is also a risk factor for NTD, but with a smaller relative risk than 677C→T mutation. Under conditions of low folate intake or high folate requirements, such as pregnancy, this mutation could become of clinical importance. We present a case report with MTHFR genetic mutation, who presented with recurrent familial pregnancy losses due to anencephaly/NTDs.
We report a rare case of prolapsed omentum presenting as mass per vagina in a 24 year old unmarried female following dilatation and curettage for termination of pregnancy by unqualified physician. Patient presented to Obstetrics and gynaecology (OBG) outpatient with bleeding per vagina since 15 days. Per speculum examination showed a greyish yellow mass protruding through cervical os into the vagina. Ultrasonography showed defect in the fundus of uterus. Past history revealed, she had undergone medical termination of pregnancy (MTP) outside at 5th month of gestation by nonallopathic doctor. Emergency laparotomy was done. Histopathologic examination of mass showed omental fat arranged in lobules with mixed inflammatory cell infiltrate. Uterine perforation is a well known complication of induced abortion. Although most uterine perforations at the time of curettage during abortion go unrecognized, serious complications do occur.
Pregnancy in the rudimentary horn of the uterus is a rare form of ectopic pregnancy; most of the cases were being diagnosed at laparotomy for haemorrhagic shock due to rupture when the patient presents in the second trimester. Pre-rupture diagnosis is possible in the early pregnancy in suspicious cases. Pregnancy in the rudimentary horn has a poor maternal and foetal outcome and 90% of them present with intraperitoneal haemorrhage in the second trimester due to rupture of the horn. We report a case of ruptured rudimentary horn pregnancy at 16weeks, in shock with severe anaemia. Excision of the rudimentary horn with right salpingectomy was done. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000): 248-250
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