Background: Congenital malformations remain a common cause of perinatal deaths and even though ultrasonogram can give fairly accurate diagnosis, perinatal autopsy is essential to confirm the diagnosis and look for associated malformations. Objectives:To emphasize the importance of perinatal autopsy in diagnosing congenital malformations and to compare the same with the prenatal ultrasound findings. Methods:The present study comprises 100 consecutive perinatal autopsies conducted after obtaining the approval from the Institutional Ethics Committee. In cases where prenatal ultrasound findings were available they were compared with the autopsy findings.Results: Out of 100 perinatal autopsies, 44 cases were congenital anomalies with M:F = 1:1.5. Majority of the fetuses with congenital malformations (36.36%) were therapeutically terminated, Cental nervous system malformations being the commonest indication. The most common timing of therapeutic termination being 20 -24weeks. Congenital malformations were common between 35-39 weeks gestational age and birth weight range 350-1000g. The malformations involving the central nervous system were commonest, seen in 15 cases (34.09%) followed by renal anomalies in 9 cases (20.45%) and multiple malformations in 7cases ( 15.91%). Autopsy confirmed the prenatal ultrasound findings in 50% of the cases, added to diagnosis in 29.54%, while it completely changed the primary diagnosis in 9.09% of the cases. Conclusion:This study highlights the importance of perinatal autopsy in confirming the diagnosis of congenital anomalies by prenatal ultrasound findings.Uma S andola, anita am, mUKta ahUja, Sainath K andola
Endometriosis is defined as the presence of endometrial-like glands and stroma outside the uterine endometrial lining. Endometrial tissue can be rarely identified on abdominal wall following numerous surgical or procedure scars, including cesarean section and hysterectomy. Cytological diagnosis of scar endometriosis is difficult, as it can be easily misinterpreted as benign spindle cells tumor. We report three cases where patients presented with a chief complaint of nodule in parietal abdominal wall adjacent to previous cesarean section scars and associated with history of cyclical pain. Provisional clinical diagnosis of desmoid tumor was made in one patient while the other two were diagnosed as endometriosis and they were referred for Fine needle aspiration cytology which revealed endometrial-like epithelial cells, stromal cells and hemosiderin-laden macrophages. Based on the cytological findings, diagnosis of Endometriosis arising in scar tissue was made which was confirmed on histopathology and wide local excision was done.
Chorangioma is the most common benign tumor of placenta, with an incidence of approximately 1%. Tumors larger than 5 cm are associated with maternal and fetal complications. We report four cases of chorangioma that were identified in mostly primigravida (75%) with a mean gestational age of 33 wks (Range 28-33 wks). All except one case, complete placenta was received with mean weight of 550 g (Range 400-800 g) and tumor size of 9.4 cm (Range 0.5-23 cm). Microscopy showed capillary proliferation resembling fetal vessels in enlarged villi covered by trophoblastic epithelium. Three cases had preterm delivery. One also presented with abruptio placenta and intrauterine fetal death. Because of limited documentation of cases and dismal prognosis of these pregnancies, especially with large chorangiomas, it's of utmost importance to correctly diagnose them with the aid of color Doppler flow. In this series, 75% of cases (3/4), babies survived probably due to small size of tumor and attainment of fetal maturity.
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