Background Aggressive angiomyxoma of the vulva is a benign, slow-growing tumor originating from myxoid cells of connective tissue. The tumor is known for multiple local recurrences with a low tendency to metastasize. Only around 350 cases have been documented in the scientific literature so far. Case presentation We report a case of a 40-year-old North Indian, unmarried woman with a swelling on the left labium majora for 7 years, along with surface ulceration over the mass. Local examination showed a well-circumscribed, 8 × 8 cm pedunculated  mass arising from the left labium majora with an overlying ulcer measuring 6 cm × 4 cm. After taking informed written consent, wide local excision of the mass and surrounding margins was done under anesthesia. Histopathology was suggestive of aggressive angiomyxoma. Immunohistochemistry was done, which was positive for estrogen and progesterone receptors. Her postoperative recovery was uneventful. The patient was given three doses of gonadotropin-releasing hormone agonist (injection, leuprolide 3.75 mg) once a month. No recurrence has been reported so far on follow-up visits for 1 year. Conclusion Aggressive angiomyxoma is one of the differential diagnoses for vulvovaginal growth in a female. As the tumor is well known for local recurrences, correct diagnosis and appropriate management using a multidisciplinary approach are crucial to managing such patients.

Background: Multiple pregnancy constitutes an important portion of high risk pregnancies and is a matter of grave concern to obstetricians and paediatricians owing to maternal and perinatal morbidity and mortality associated to it. Objective of present study was to evaluate maternal and perinatal outcome of twin pregnancy.Methods: This observational study included 50 women with twin pregnancy with gestational age of 26 weeks or more. Maternal and perinatal outcomes were studied.Results: The incidence of twin pregnancy was 2.8 % with maximum incidence in age group of 20 -29 years and in multigravida. Mean gestational age was 34.2 weeks. Vertex - vertex fetal presentation was most common presentation. Most frequent mode of delivery was ceserean section (54%). Preterm labour was most common maternal complication (74%), followed by anaemia (62%). Complications in perinatal period were birth hypoxia (58 %), intrauterine growth restriction (15 %), hyper-bilirubinemia (11%) and neonatal sepsis (10 %). 88% of the newborns were LBW. Perinatal mortality in our study was 17%.Conclusions: Twin pregnancies are associated with significant maternal and perinatal morbidity which is more so for second twin. Effective antenatal care planned delivery and good pediatric facilities help decrease the complications. Managment of twin pregnancy requires multidisciplinary approach and involvement of skilled obstetricians and paediatricians.

Background: Unsupervised medical abortion pill intake is becoming a public health hazard. Because of its widespread misuse, we planned to undertake this study to evaluate the clinical presentation and outcome of such patients.Methods: Hundred patients meeting inclusion criteria were included. Clinical presentation, treatment given and, outcome and complications were analyzed.Results: Majority (53%) patients were aged between 30-39 years. Seventy-seven percent were gravida three or more. Only 26% had taken the pill within prescribed gestational age limit for MTP (<seven weeks). Mid-trimester pill intake was encountered in 13 % patients. Pill was consumed without any prior medical consultation by 73% patients. Majority (49%) presented with incomplete abortion requiring surgical evacuation. Anaemia was most common associated co-morbidity in 80% patients and 28% required blood transfusions. Twenty-four percent patients presented with life threatening shock. Sepsis was noted in 3% patients. Emergency laprotomy was required in 11% cases. Continuation of pregnancy was reported in 13% patients. Unintended pregnancy and failure of contraception were main reasons cited for abortion by 38% and 26% women. Non-contraceptive users constituted 48% patients . Over the counter easy availability was the main reason for unsupervised pill intake in 58% cases.Conclusions: Unauthorized over the counter pill availability despite legal ban and ignorance of women have led to increased number of unsafe abortions. Strict legislations need to be imposed. Increasing awareness among women regarding complications of unsupervised pill intake and easy availability of safe contraceptive methods can help control this problem.

Chronic oligohydramnios due to any cause can have grave foetal prognosis. One of the rare complications is Potter's sequence which occurs as a result of intrauterine mechanical compression of the foetus due to decreased liquor volume. This case report aims to give an insight into this rare complication. Classical Potter's sequence is due to renal cause whereas non classical, a still rarer variant of Potter's sequence is due to non renal cause. We describe a case of a lady at 38 weeks of gestational age with chronic oligohydramnios due to prolonged leaking per vaginum and severe intrauterine growth restriction. She delivered a congenitally malformed male baby with features of Potter's sequence. The renal abnormalities were conspicuously absent in our case, suggesting a diagnosis of non classical Potter sequence.

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