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INTRODUCTIONPremature rupture of membranes is an enigmatic condition associated with high risk of maternal and perinatal morbidity and mortality and has management strategies that are often diverse and controversial. Premature rupture of membranes is defined as spontaneous rupture of fetal membranes beyond 28weeks of pregnancy but before the onset of uterine contractions. 1It occurs in approximately 10% of all pregnancies and in 70% of the cases it occurs in pregnancies at term. 1,2Premature rupture of membranes results from accelerated membrane weakening by various factors through an increase in local cytokines and an imbalance between MMPs and TIMPs, increased protease and collagenase activity and factors that cause increased intrauterine pressure.3 Although vaginal GBS colonization does not appear to be associated with PROM, GBS bacteruria has been associated with preterm PROM and low birth weight infants. 4,5 PROM at term is defined as the leakage of amniotic fluid beginning atleast 1 hour prior to onset of labour >37 weeks of gestational age. Approximately 80% of PROM ABSTRACT Background: Premature rupture of membranes is defined as spontaneous rupture of fetal membranes beyond 28weeks of pregnancy but before the onset of uterine contractions. It occurs in approximately 10% of all pregnancies and in 70% it occurs at term. If PROM occurs before 37 completed weeks, it is referred as preterm premature rupture of membranes(PPROM). PROM is associated with adverse outcomes in both, hence its management becomes crucial. It complicates 8% of pregnancies. Objective of present study was to investigate the labour, maternal and perinatal outcomes. Methods: 75 patients who entered labour room at term with PROM were taken as cases and those with intact membranes as controls. Investigations are sent, and prophylactic antibiotics were given. Progress of labour, PROM delivery interval, method of induction, mode of delivery along with maternal and fetal outcomes, total duration of hospital stay was noted and compared with controls. Results: Rate of caesarean is higher in study group (14.7%) and failure to progress was the common indication. Intrapartum morbidity was higher in the study group (16%) and perinatal morbidity was 20%. NICU admission and the need for antibiotics were higher in study group and hence longer duration of hospital stay. Conclusions: PROM is associated with increased incidence of neonatal sepsis and subsequently antibiotics given were higher in cases. There is a higher incidence of caesarean rates and hospital stay. Proper screening of high risk cases and appropriate management is suggested to reduce perinatal morbidity.

Aim To present a rare case of struma ovarii in a 46-year-old lady presenting with features pointing toward malignancy. Background Struma ovarii is a specialized or monodermal teratoma, which is predominantly composed of mature thyroid tissue. It accounts for less than 5% of all ovarian teratomas. It is mostly benign, and malignant changes are extremely rare. Most patients are asymptomatic or may present with mild signs and symptoms. Although the vast majority are benign, they may rarely present mimicking malignancy. Case description A 46-year-old lady presented with a large complex abdominopelvic mass with ascites and elevated CA-125 levels, thus arising suspicion of malignancy. Postoperatively, histopathology revealed a benign struma ovarii, which was further confirmed by immunohistochemistry. Conclusion Struma ovarii can imitate ovarian malignancy clinically, especially if it is complex and found in combination with ascites and an elevated CA-125 level. There is paucity of literature about such cases, and hence, it makes an accurate and timely diagnosis difficult. Clinical significance This case is one of the very few that provide a description of an atypical presentation of a rare tumor, struma ovarii. A high level of clinical suspicion may help with better preparedness before surgery and prevent extensive laparotomies in such patients. How to cite this article Chandra S, Shetty S, Mallya V, et al. Masked Tumor: A Rare Presentation of Struma Ovarii Disguised under Features Imitating Malignancy. J South Asian Feder Obst Gynae 2020;12(6):436–437.