Intramural ectopic pregnancy is one of the rarest types of ectopic pregnancy,with risk of 1:30000.Confirmation of intramural ectopic pregnancy is difficult and is often performed intraoperatively.Intramural ectopic pregnancy often requires hysterectomy to avoid life-threatening haemorrhage.We present a case of intramural ectopic pregnancy in the second trimester.Transvaginal ultrasound and MRI are important non-invasive methods in diagnosing this type of ectopic pregnancy.Clinicians should provide consideration to a combination of strategies and do their best to preserve patient’s ”uteri and fertility”.
Background: Pre-eclampsia refers to any new onset of hypertension and proteinuria after 20 weeks of gestation in a previously normotensive, non proteinuric women. Hypertension is a very common medical complication of pregnancy. It is one of the leading causes of maternal and fetal mortality and morbidity worldwide. Early detection, close surveillance and timely delivery are necessary to reduce complications and improvement in maternal and fetal health and outcome. To determine the incidence, risk factors and maternal and fetal outcomes in women with hypertensive disorders of pregnancy in all pregnant women attending Obstetrics and Gynaecology department, Shanakaracharya Institute of Medical Science, Bhilai.Methods: This is a retrospective record-based observational study conducted over a period of one year from January 2020-December 2020 after getting approval from the institutional ethical committee. Patients diagnosed with hypertensive disorders of pregnancy were evaluated and data was collected and analyzed.Results: Of the 1503 deliveries in the hospital during the period under review, 131(8.7%) were managed for hypertensive disorders of pregnancy. Pre-eclampsia was the commonest type of hypertensive disorder of pregnancy (69.3%) with the majority presenting with severe disease. Women of all age group were affected with highest incidence among 21-30years of age (69.4%). The incidence was maximum among primigravida (67.2%) compared to multipara 100 (32.8%). Intra uterine deaths were recorded among 12.2%, while a major share of fetus (41.2%) were diagnosed to have intrauterine growth retardation. Most common maternal complication in our study was abruption (7.6%), followed by HELLP (2.2%). Two maternal deaths were recorded, giving a case fatality rate of 1.5%.Conclusions: Hypertensive disorders of pregnancy are associated with high maternal and fetal morbidity and mortality. Regular antenatal follow up will help in early diagnosis and timely intervention of the cases. Also, special consideration and close surveillance of those women with early-onset disease is important. There is need for strengthening of communication and referral systems in the healthcare.
Background: Antepartum haemorrhage has always been one of the deadliest complications in obstetrics. Antepartum haemorrhage (APH) complicates about 2-5% of pregnancies. Maternal and perinatal morbidity and mortality associated with APH can be reduced significantly by aggressive expectant management. The present study was conducted to assess maternal and fetal outcome in patients with antepartum haemorrhage. Aims and objectives were to study the incidence of antepartum haemorrhage at SSIMS hospital. To highlight the importance of early diagnosis and treatment. To study the maternal and fetal outcome in antepartum haemorrhage. To study the associated risk factors contributing to maternal and fetal morbidity and mortality.Methods: The study was conducted in Shri Shakaracharya Institute of Medical Sciences, Bhilai, Durg, Chhattisgarh during the period of January 2020 to December 2020 after getting approval from the institutional ethical committee. 31 cases of APH with gestational age ≥28 weeks were included. They were distributed according to type of APH into abruptio placentae (AP), placenta previa (PP). Causes of APH were noted and maternal as well as perinatal outcome observed.Results: In the present study it was observed that incidence of APH was 2% out of 1503 deliveries. Out of 31 cases, 54.83% was AP followed by PP 45.16%. Abruption was the commonest cause of APH with its associated maternal morbidity and perinatal mortality and morbidity. Anemia was the most common complication in APH. Prematurity of the neonate was a serious complicating factor in APH. No maternal mortality was seen in this study.Conclusions: Overall incidence of APH has remained high. Though maternal morbidity is reduced with modern management of APH, but timely diagnosis and intervention is necessary. Perinatal morbidity can be reduced with good neonatal intensive care facilities.
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