Endometriosis can be defined as the presence and growth of functioning endometrial tissue (glands and or stroma) outside the endometrium. Occasionally, surgical scars are the sites of endometriotic implantation particularly perineal scars (episiotomy). Perineal scar endometriosis is a very rare condition, its incidence rate was about 0.03-0.15%. Perineal scar endometriosis mainly affects young females at the episiotomy site following a previous vaginal delivery. A 29 years old patient presented with swelling at the site of episiotomy which was associated with pain during menstruation. On examination a palpable mass was revealed without induration at close proximity to episiotomy scar site during menstruation. MRI pelvis is the most commonly used imaging technique for the diagnosis of perineal endometriosis as well as to assess the deeper extent of the lesion. Mass excised and sent for histopathological examination. Wide local excision is the definitive treatment for surgical site endometriosis. Follow up is recommended for recurrence. The rare possibility of malignant transformation, can be excluded by histopathological examination of excised tissue.
Pregnant women presenting with isolated cranial palsies are uncommon. Isolated sixth nerve (abducens nerve) palsy can occur for a variety of reasons and neuroimaging is often performed to identify an underlying cause. We report a case of a woman in her third pregnancy with preeclampsia who presented with an isolated sixth nerve palsy. The diagnosis of aseptic cavernous sinus thrombosis was made and she subsequently made a full recovery.
Purpose: Infertility has been highly prevalent in recent years and has social implications. With the development of novel treatments, there is a rise in complications. This study aims to assess the maternal and perinatal outcomes of pregnancies following a period of infertility. Materials and methods: A cross-sectional analytical study of 140 women admitted to the labor room in a tertiary care center in South India from September 2014 to May 2016 with conceptions following a period of infertility was recruited in group I. A total of 140 controls with spontaneous conceptions within 1 year of married life were recruited in group II. Data were collected using a pre-designed proforma after obtaining informed consent. Various maternal and perinatal outcomes between the two groups were analyzed and compared. Chi-squared test/Fischer's exact test was used to compare the two groups' outcomes. Results: The incidence of hypertensive disorders [odds ratio (OR) = 2.2; 95% confidence interval (CI): 1.2-4.2], gestational diabetes mellitus (GDM) (OR = 3.6; 95% CI: 1.7-7.5), and preterm labor (OR = 3.5; 95% CI: 1.6-7.8) were significantly higher in group I compared to group II. Among the fetal outcome, the number of neonatal intensive care unit (NICU) admissions (OR = 5.57; 95% CI: 2.5-13.1), low birth weight (LBW) (OR = 3.02; 95% CI: 1.8-4.9), and neonatal morbidity (OR = 7.8; 95% CI: 1.5-14.8) were significantly higher among group I. However, there were no statistically significant differences in the perinatal outcome among the different treatment groups. Conclusion: Pregnancies following infertility are at a higher risk of some obstetric complications and adverse perinatal outcomes than spontaneous conceptions and hence require close follow-up and timely intervention.
Sirenomelia is a rare congenital malformation wherein the two lower limbs are fused to give an appearance of a mermaid. It is almost always lethal and is associated with several other defects like anorectal malformations, renal agenesis, umbilical cord vessel abnormalities and gastrointestinal defects. Reporting this case of sirenomelia from our institution in a preterm baby born alive to a primigravida at 36 weeks of gestation, who presented in labour.
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