Background Incidence of jaundice in pregnancy, including underlying chronic liver diseases, is 3-5%. However, the maternal mortality rate in some conditions can be as high as 18% in acute fatty liver of pregnancy and 22% in hepatitis E in pregnancy. Objectives This is an observational study of the demographics, obstetrical profile, aetiology, maternal morbidity, mortality and neonatal outcomes in pregnancies complicated with jaundice. Materials and Methods This is an observational study conducted in Department of Obstetrics and Gynaecology of a tertiary care hospital, situated amidst the biggest urban slum in Mumbai spanning over 1 year from January 2016 to December 2016. All registered, unregistered and transferred patients with abnormal liver function tests excluding patients with chronic liver diseases were included in this study. Results Most of the cases of jaundice in pregnancy were seen in primigravida (51%) and age group of 20-30 years (58%). Fifty-three percentage of cases were referred or transferred from periphery hospitals. Hepatitis E was the
Incidence of adherent placenta is on the rise nowadays due to various reasons. Placenta percreta is seen in 5-7% of cases with adherent placenta, patients with morbidly adherent placenta are at increased risk for major obstetric hemorrhage, usually in the third trimester. Here we present an unusual case of placenta percreta presenting with obstetric emergency after trauma to abdomen in the second trimester. Emergency exploratory laparotomy was done for abruptio placentae with scar dehiscence at 20 weeks period of gestation. Consent for obstetric hysterectomy, if needed, was also taken. Intraoperatively, the placenta was found to be adherent to posterior wall of bladder. Emergency obstetric hysterectomy with bilateral internal iliac ligation with cystoscopy with detrusorrhaphy was done. Patient had an uneventful recovery. Multidisciplinary management with obstetricians, urologists and intensivist is presented hereed.
BACKGROUNDA 22-year-old Gravida 4, Para 2, Living 2, MTP 1, previous 2 lower segment caesarean sections with 36 weeks of gestation presented with scar tenderness. An emergency lower segment caesarean section was performed. A huge ovarian cyst was found during lower segment caesarean section which was successfully excised. The patient had good feto-maternal outcome.
Incidence of ovarian malignancy in children and adolescents is 1 to 1.5% with non-epithelial tumors being the most common type. Ovarian mucinous tumors commonly seen in third to sixth decade, are rarely seen in adolescents. Timely diagnosis and management are important to save patient’s life and fertility. We are presenting an interesting case of a 16-year-old girl with atypical borderline mucinous ovarian tumor.
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