Thoracic endometriosis syndrome is a rare disorder characterised by the presence of functioning endometrial tissue in pleura, lung parenchyma, airways, and/or encompasses mainly four clinical entities-catamenial pneumothorax, catamenial haemothorax, catamenial haemoptysis and lung nodules. The cases were studied retrospectively by reviewing the records at Amrita Institute of Medical Sciences, for duration of five years i.e., form March 2010-2014 and analysed for the clinical presentation and management of thoracic endometriosis syndrome. Catamenial breathlessness was the main symptom. Pneumothorax and pleural effusion were the findings on investigations. Histopathology report of endometriosis was present in three cases (50%). Conditions with excess oestrogen like endometriosis, fibroid, adenomyosis were diagnosed in these patients by pelvic scan. After the initial supportive treatment with hormones, pleurodesis, hysterectomy and lung decortication were the treatment modalities. Two cases that had multiple recurrences were diagnosed as disseminated TES. They underwent combined treatment of surgery and hormones.

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A 25-year-old woman presented to our out-patient department with history of 6 weeks amenorrhoea and with complaints of 1 episode of spotting per vaginum, mild intermittent abdominal pain, predominantly in the umbilical region and nausea since 1 day. She was a primigravida and a known case of hypothyroidism, on hormone replacement since 2 years. She was haemodynamically stable. On per abdominal examination there was minimal tenderness and no mass was palpable. Per speculum examination revealed minimal blood stained discharge through the os. There was no mass palpable in both fornices or cervical motion tenderness, with the uterus being of normal size and anteverted on vaginal examination. Laboratory investigations showed urine pregnancy test was positive and Serum BHCG measured 24,719mIU/ml. Her haemogram was normal.Trans vaginal ultrasonography revealed an empty uterus with a 3x3.5cm right adnexal mass containing a foetal pole of 7 weeks gestation [Table/ Fig-1]. Foetal cardiac activity was noted and there was no free fluid in the cul de sac. Since the patient was stable and the findings suggested unruptured tubal pregnancy. Laparoscopy was undertaken after relevant preparation. A 3x3.5cm abdominal pregnancy [Table /Fig-2,3] was found in the right broad ligament with minimal blood in the cul de sac. The right tube, uterus, left adnexa appeared normal. The rest of the viscera were normal. The right broad ligament was opened and the sac was excised, products of conception extruded. There was excess bleeding Keywords: Abdominal pregnancy, Ectopic pregnancy, Endoscopic surgery, Intra ligamentary pregnancy Obstetrics and Gynaecology SectionBroad Ligament Pregnancy -Success Story of a Laparoscopically Managed Case JayaShree Nayar 1 , SObha S. Nair 2 ABSTRACTAbdominal pregnancies constitute 1% of ectopic pregnancies, among which broad ligament pregnancy is a rare form. The maternal mortality rate has been reported to be as high as 20%. The diagnosis is seldom established before surgery. Laparoscopic management of broad ligament ectopic pregnancy is the ideal form of treatment in appropriately selected patients.We present the case report of successful laparoscopic treatment of a 3x3.5cm broad ligament pregnancy. A search of literature shows that ours is the 6 th case report of such a rare ectopic pregnancy managed endoscopically successfully. from the site, which could not be controlled by cauterisation of the vessels and ultimately resulted in right salpingectomy.

Non cephalic presentation at diagnosis of PPROM is likely to have an unfavorable effect on the maternal and fetal outcome.

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Background: Placental location can be estimated easily using ultrasonogram by 16 weeks. It can be classified based on its location into central and lateral. Central can be anterior or posterior. Lateral can be left lateral or right lateral. Placental location has been attributed to both normal and abnormal pregnancy and neonatal outcomes.Methods: This is a prospective cohort study conducted in the department of Obstetrics and Gynecology which comprised of 450 singleton gestations between 18 and 24 weeks. The primary objective is to determine the association between placental location and pregnancy outcome and secondary objective is to find out the association between placental location and neonatal outcome. The study population was divided into two groups – central and lateral. Results were analyzed using SPSS version 20, Chi square test and independent two sample t-test.Results: The frequency of central placenta was 377 (83.8%) and lateral placenta in 73 (16.2%). Central placentation had an abnormal outcome in 182(48.3%), lateral placentas with abnormal outcome were 44(60.3%). Abnormal maternal outcomes like hypertensive disorders (33.3%), Intra Uterine Growth Restriction (10.2%), Antepartum haemorrhage (25%), Preterm birth (16.3%) were more in lateral placentation. The number of central placentas having NICU admissions were 62(16.4%) and lateral placenta with NICU admissions were 19(26%).Conclusions: There is a significant association between lateral placentation and abnormal pregnancy and neonatal outcomes. Second trimester ultrasound can be used as non-invasive predictor of adverse pregnancy and neonatal outcomes.

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