Objective To determine the maternal and perinatal outcome after expectant management of severe pre-eclampsia between 24 and 34 weeks of gestation. Method The maternal and fetal status was monitored by an intensive, non-invasive method among 94 women with severe pre-eclampsia between 24 and 34 weeks of gestation who were scheduled for expectant management in the OICU at a tertiary care center. Pregnancy prolongation and maternal and perinatal morbidity and mortality were analyzed by the Student 't' test and the Mann-Whitney U test. Results The days of pregnancy prolongation and perinatal mortality were significantly higher among those managed at \30 weeks. Increasing gestational age correlated with a reduction of RDS. Maternal morbidities were significantly higher among those managed at\28 weeks. But, there was no maternal mortality. Conclusion Expectant management of severe preeclampsia at 30-34 weeks in a tertiary care center of a developing country is associated with good perinatal outcome and risk reduction for the mother.

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Scar endometriosis is an uncommon condition in which endometrial tissue grows in a previous surgery wound site. The triad of scar endometriosis includes the history of caesarean section or any other gynecological surgery, cyclical waxing, and waning pain accompanied by the patient's menstrual cycle and a tumor inside/near the scar site. Here, we present a case report in which the patient presented with endometriosis at the previous caesarean section scar site. She had classical clinical and imaging characteristics for scar endometriosis. However, histopathology was not diagnostic for the same. The pathogenesis, presentation, diagnosis, and management are discussed briefly. The diagnosis of scar endometriosis is based on clinical presentation and imaging. Fibrosis on histopathology is an important component of endometriosis that cannot be overlooked.

Background Ca cervix is the most common cancer among women in developing countries. In developed countries, screening is done by Pap smear which is resulting in drastic decrease in ca cervix which is not so in developing countries due to various reasons. So visual inspection of cervix can be cost effective screening procedure if its efficacy is proved in low resource countries. OBJECTIVE: To determine which screening method is efficient in detecting premalignant & malignant lesions of ca cervix in resource poor settings. METHODS: Pap smear was done in all 600 women, along with this VIA in 200 women, VILI in 200 women was done. Either pap or VIA or VILI positive cases were selected for colposcopy followed by biopsy if positive findings were there on colposcopy. 10% of either screening negative cases were subjected for biopsy to know false negative rate from each group. Main outcome measures: comparison of all three screening methods (pap smear, VIA, VILI) in terms of sensitivity, specificity, PPV, NPV in comparison with gold standard colposcopic guided cervical biopsy. RESULTS: The aided visual inspection has more PPV than pap smear, The sensitivity of all three screening methods were comparable. The specificity & NPV of pap smear were high. CONCLUSION: So the aided visual inspection can be used as screening method in detection of premalignant and malignant lesions of cervix in place of papsmear especially in rural setting.

At 19 weeks 6 days ultrasonography of a 31-year-old G2P1L1 revealed a small echogenic area seen in the subvalvular apparatus of the mitral valve (anterior mitral leaflet) suggestive of cardiac rhabdomyoma (CR). At 28 weeks of gestation there was mild increase in the size of the CR (13 × 6 mm). There was no evidence of hemodynamic compromise. The interval growth of the fetus was satisfactory. The family tree of three generations was examined and revealed no evidence of Tuberous Sclerosis. She delivered a live 34 weeks 2.2 kg male baby with 8 and 9 Apgar scores at 5 and 10 minutes respectively. Baby suddenly developed cyanosis and died 24 hours after birth. The fetal autopsy confirmed the diagnosis of CR. Genetic analysis of neonatal blood revealed no evidence of TSC mutation suggestive of tuberous sclerosis.