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A 27-year-old primigravida with seven months gestation presented with complaints of pain abdomen and vomiting for last three days. She has been treated twice in the past for similar complaints in some local hospitals. There is also past history of dysmenorrhea with scanty menstrual flow in each cycle. Medical and surgical history was inconclusive. General physical examination was unremarkable. Uterus was of 26 week size and relaxed, with a firm oblong tender mass (10cm x 8cm x 6cm) felt on the right iliac fossa arising from the pelvis and attached to the right side of uterus with restricted mobility. Vaginal examination showed a large cystic bulge in the right lateral vaginal wall that was non-tender, tense and contained fluid. On the left side, cervix was seen with the help of a long bladed speculum, whereas the right side cervix could not be felt as there was a vaginal septum partially obstructing the vagina [Table/ Fig-1].Laboratory investigation showed hemoglobin of 8.8 g%, WBC count of 16800/cumm with 85% polymorphs. Renal and liver function tests were normal. Ultrasonography showed a single, live fetus of 27+3 weeks gestation with adequate liquor. A separate uterine cavity (without communication with the main uterine cavity) with heterogeneous collection was seen towards right of the pregnant uterus [Table/ Fig-2]. A septum is also visible extending from the midpelvis up to the introitus. A cystic swelling (8cm × 7cm × 6cm) posterior to bladder, in continuation of the right uterine cavity (nonpregnant) with echogenic collection was present. The findings pointed towards vaginal location of the collection. Rest of the abdominal organs including the ovaries were normal.Through transperineal approach under general anaesthesia, a transverse incision was given over the cyst after catheterizing the bladder, and around one litre of pus was drained [Table/ Fig-3]. Intravenous antibiotics were given. Patient was relieved of her symptoms. Follow up ultrasonography after 48 h revealed complete disappearance of pyocolpos. She was kept under follow up which was uneventful. Finally, she delivered a female child at 37+3 week gestation by normal vaginal delivery.

Background: Vitamin D deficiency has been associated with various poor maternal and fetal outcome and is proposed to be important in the pathogenesis of preeclampsia. The aim of the study was to evaluate the serum vitamin-D levels in normal pregnant females and pre-eclampsia or eclampsia individuals in the third trimester admitted for termination or in labour and to assess the neonatal outcome and neonatal serum calcium levels of babies born to mother in both the groups.Methods: This study was a prospective comparative study carried out on the pregnant women in the third trimester admitted for termination or in labour. 100 pregnant females with either pre-eclampsia or eclampsia were compared with equal number of normotensive pregnant females for serum vitamin D. They were followed up until delivery and subsequently neonatal serum calcium level was estimated.Results: Most pregnant females had vitamin D deficiency pointing towards universal prevalence. Only 10% had suboptimal to optimal vitamin D level while 90% had vitamin deficiency. The hypertensive group had lower mean serum vitamin D level (9.06±5.20 ng/ml) as compared to normotensive group (13.67±7.24 ng/ml). Neonatal outcome was poorer in the hypertensive group. Neonates born to hypertensive mothers had lower mean calcium level (8.30±1.46mg/dl) when compared to those born to normotensive mothers (8.82±0.918mg/dl).Conclusion: The study findings revealed that there lies a consistent association of maternal serum vitamin D deficiency with the hypertensive disorders of pregnancy and neonatal morbidity.

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